Provider Demographics
NPI:1578107744
Name:ALWANI, AMBREEN (FNP)
Entity Type:Individual
Prefix:MRS
First Name:AMBREEN
Middle Name:
Last Name:ALWANI
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 DEFOREST RD
Mailing Address - Street 2:
Mailing Address - City:COPPELL
Mailing Address - State:TX
Mailing Address - Zip Code:75019-2740
Mailing Address - Country:US
Mailing Address - Phone:469-569-0581
Mailing Address - Fax:
Practice Address - Street 1:917 DEFOREST RD
Practice Address - Street 2:
Practice Address - City:COPPELL
Practice Address - State:TX
Practice Address - Zip Code:75019-2740
Practice Address - Country:US
Practice Address - Phone:469-569-0581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-31
Last Update Date:2019-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143852363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily