WEST, SUNDYE MARIE (FNP-C)

Provider Demographics

• NPI: 1891797627
• Name: WEST, SUNDYE MARIE (FNP-C)
• Entity Type: Individual
• Prefix: MS
• First Name: SUNDYE
• Middle Name: MARIE
• Last Name: WEST
• Gender: F
• Credentials: FNP-C
• Other - First Name: SUNNY
• Other - Middle Name: MARIE
• Other - Last Name: WEST
• Other - Last Name Type: Other Name
• Other - Credentials: FNP
• Mailing Address - Street 1: 141 INDUSTRIAL AVE
• Mailing Address - City: AZLE
• Mailing Address - State: TX
• Mailing Address - Zip Code: 76020-2901
• Mailing Address - Country: US
• Mailing Address - Phone: 817-444-3231
• Mailing Address - Fax: 817-444-3234
• Practice Address - Street 1: 141 INDUSTRIAL AVE
• Practice Address - City: AZLE
• Practice Address - State: TX
• Practice Address - Zip Code: 76020-2901
• Practice Address - Country: US
• Practice Address - Phone: 817-444-3231
• Practice Address - Fax: 817-444-3234
• Is Sole Proprietor?: No
• Enumeration Date: 2005-08-11
• Last Update Date: 2022-02-22

Provider Licenses

State	License ID	Taxonomies
TX	AP112957	363LF0000X

Provider Taxonomies

Primary?	Code	Type	Classification	Specialization
Yes	363LF0000X	Physician Assistants & Advanced Practice Nursing Providers	Nurse Practitioner	Family

Provider Identifiers

State	Identifier ID	ID Type	Issuer
TX	182010209	Medicaid
TX	182010205	Medicaid
TX	182010206	Medicaid
TX	182010203	Medicaid
TX	182010207	Medicaid
TX	182010202	Medicaid
TX	8B7163	Other	MEDICARE PROVIDER NUMBER
TX	182010204	Medicaid
TX	TXB121637	Medicare PIN
TX	8L10039	Medicare PIN
TX	182010206	Medicaid
TX	182010207	Medicaid
TX	8L6435	Medicare PIN
TX	8L6454	Medicare PIN
TX	182010202	Medicaid
TX	8L10038	Medicare PIN
TX	8L9701	Medicare PIN
TX	TXB121639	Medicare PIN