Provider Demographics
NPI:1922413095
Name:AMADI, RENE HABINUCHI (FNP-C)
Entity Type:Individual
Prefix:
First Name:RENE
Middle Name:HABINUCHI
Last Name:AMADI
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1340 N HIGHWAY 377
Mailing Address - Street 2:STE 110
Mailing Address - City:PILOT POINT
Mailing Address - State:TX
Mailing Address - Zip Code:76258-3764
Mailing Address - Country:US
Mailing Address - Phone:940-686-0860
Mailing Address - Fax:940-686-5834
Practice Address - Street 1:1340 N HIGHWAY 377
Practice Address - Street 2:STE 110
Practice Address - City:PILOT POINT
Practice Address - State:TX
Practice Address - Zip Code:76258-3764
Practice Address - Country:US
Practice Address - Phone:940-686-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP125884363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily