NPI Profile for BLUE AGAVE WOUND CARE SOLUTIONS LLC in AUSTIN, TX.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Wound Care |
163WW0000X | |||
Home Health |
364SH0200X | 89 | Certified Clinical Nurse Specialist | |
Home Health |
163WH0200X | |||
Home Health Aide |
374U00000X | |||
Nurse Practitioner |
363L00000X | 50 | Nurse Practitioner |
| NPI # | 1851869234 |
|
| Status | Active | |
| Credentials | ||
| Entity | Individual | |
| Enumeration date | 11/05/2018 | |
| Last updated | 11/05/2018 - About 8 years ago | |
| Sole proprietor 1 | Not specified | |
| Identifiers | Not Available | |
| Hospital affiliation(s) | Not Available |
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