Plourde, Sally B

Plourde, Sally B is an individual health care provider with primary practice located at 6425 S Ih 35 Ste 100 , Austin TX 78744-4230. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Plourde, Sally B can be contacted via phone (512) 744-6000.

Contact Information

Primary practice address
6425 S Ih 35 Ste 100 Austin TX 78744-4230
Phone: (512) 744-6000
Fax: (512) 225-6520
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 541988 Texas
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 364SP0200X AP121376 Texas

Profile Details

NPI number 1831442490
LBN Legal business name Plourde, Sally B
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2012
Last updated Apr 19th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831442490 NPPES
Texas MEDICAID 3280315-02

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