Provider Demographics
NPI:1861454381
Name:AUSTIN, VIRGINIA KATHLEEN (RN, BSN, RNFA)
Entity Type:Individual
Prefix:MRS
First Name:VIRGINIA
Middle Name:KATHLEEN
Last Name:AUSTIN
Suffix:
Gender:F
Credentials:RN, BSN, RNFA
Other - Prefix:MS
Other - First Name:VIRGINIA
Other - Middle Name:KATHLEEN
Other - Last Name:FORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, BSN, RNFA
Mailing Address - Street 1:9999 BOAT CLUB RD
Mailing Address - Street 2:#601
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-4091
Mailing Address - Country:US
Mailing Address - Phone:817-907-2918
Mailing Address - Fax:
Practice Address - Street 1:9999 BOAT CLUB RD
Practice Address - Street 2:#601
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76179-4091
Practice Address - Country:US
Practice Address - Phone:817-907-2918
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-03
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX648218163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse