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Individual
MIREYA VANDERSLICE
Active
Individual
MIREYA VANDERSLICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
700867
TX
363LF0000X
Family Nurse Practitioner
Primary
AP114967
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212528802
WELLMED MEDICAID
TX
01
—
TXB153249
WELLMED MEDICARE
TX
Enumeration date
08/15/2006
Last updated
09/24/2024
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