Individual
ANNETTE L. BACON
Active
Individual
ANNETTE L. BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
WHCNP
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
530649
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
157515101
—
TX
05
—
157515102
—
TX
05
—
157515103
—
TX
05
—
157515104
—
TX
05
—
157515105
—
TX
05
—
157515106
—
TX
05
—
157515107
—
TX
05
—
157515108
—
TX
05
—
157515109
—
TX
05
—
157515110
—
TX
05
—
157515111
—
TX
01
—
8Y1538
BLUE CROSS BLUE SHIELD
TX
Enumeration date
12/21/2006
Last updated
02/19/2009
Update your record
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