Individual
MARILYN OMOMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGPCNP, PMHNP
Contact information
Practice address
6101 W COURTYARD DR STE 2-225, AUSTIN, TX 78730-5044
(512) 956-5003
Mailing address
PO BOX 844658, DALLAS, TX 75284-4658
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
785075
TX
363LG0600X
Gerontology Nurse Practitioner
AP127499
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP127499
TX
Other
Enumeration date
01/29/2015
Last updated
08/21/2024
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