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Individual

COURTNEY HELMAN SUPON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN, FNP-C

Contact information

Practice address
6835 AUSTIN CENTER BLVD, AUSTIN, TX 78731-3166
(512) 346-6611
(512) 406-7315
Mailing address
4515 SETON CENTER PKWY, SUITE 215, AUSTIN, TX 78759-5290

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
95003474
CA
363LF0000X
Family Nurse Practitioner
Primary
AP129597
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
358112601
TX
05
358112602
TX
Enumeration date
01/08/2016
Last updated
02/01/2018
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