Provider Demographics
NPI:1952843617
Name:WU, ANN (MS, CNS)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:
Last Name:WU
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 BOULDIN AVE UNIT B
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78704-1613
Mailing Address - Country:US
Mailing Address - Phone:858-354-7674
Mailing Address - Fax:737-247-4760
Practice Address - Street 1:901 BOULDIN AVE UNIT B
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78704-1613
Practice Address - Country:US
Practice Address - Phone:858-354-7674
Practice Address - Fax:737-247-4760
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-12
Last Update Date:2016-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist