Provider Demographics
NPI:1619535242
Name:BELTOWSKI, IWONA ELZBIETA (APRN, AGPCNP-BC)
Entity Type:Individual
Prefix:
First Name:IWONA
Middle Name:ELZBIETA
Last Name:BELTOWSKI
Suffix:
Gender:F
Credentials:APRN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2321 OLYMPIA DR
Mailing Address - Street 2:
Mailing Address - City:FLOWER MOUND
Mailing Address - State:TX
Mailing Address - Zip Code:75028-1898
Mailing Address - Country:US
Mailing Address - Phone:386-216-4712
Mailing Address - Fax:
Practice Address - Street 1:2321 OLYMPIA DR
Practice Address - Street 2:
Practice Address - City:FLOWER MOUND
Practice Address - State:TX
Practice Address - Zip Code:75028-1898
Practice Address - Country:US
Practice Address - Phone:386-216-4712
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-29
Last Update Date:2020-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX876807163WC0200X
TXAP140421363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine