Provider Demographics
NPI:1639656473
Name:ADVANCE PRACTICE NURSE CONSULTANTS PLLC
Entity Type:Organization
Organization Name:ADVANCE PRACTICE NURSE CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIK
Authorized Official - Middle Name:
Authorized Official - Last Name:TIJERINA
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:903-539-2958
Mailing Address - Street 1:210 S CANTON ST
Mailing Address - Street 2:
Mailing Address - City:MABANK
Mailing Address - State:TX
Mailing Address - Zip Code:75147-2367
Mailing Address - Country:US
Mailing Address - Phone:903-539-2958
Mailing Address - Fax:
Practice Address - Street 1:874 ED HALL DR STE 106
Practice Address - Street 2:
Practice Address - City:KAUFMAN
Practice Address - State:TX
Practice Address - Zip Code:75142-1800
Practice Address - Country:US
Practice Address - Phone:903-539-2958
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-24
Last Update Date:2018-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX693274363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX693274OtherTEXAS BOARD OF NURSING