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Individual

PIA ERIKA HABERSANG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1901 MEDI PARK DR, STE 2051, AMARILLO, TX 79106-2169
(806) 468-4300
(806) 468-4398
Mailing address
1400 WALLACE BLVD, ATTN: CREDENTIALING DEPT., AMARILLO, TX 79106-1708
(806) 468-4300
(806) 468-4398

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
445651
TX
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
445651
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
042484804
TX
05
042484805
TX
05
200310180 A
OK
05
53936353
NM
Enumeration date
07/21/2008
Last updated
06/24/2013
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