Individual
ASSIA L PHOENIX
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-C
Contact information
Practice address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-3725
(210) 292-5806
Mailing address
1100 WILFORD HALL LOOP, JBSA LACKLAND, TX 78236-5638
(210) 292-3725
(210) 292-5806
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP144888
TX
363LF0000X
Family Nurse Practitioner
AP144888
TX
Other
Enumeration date
08/20/2020
Last updated
08/25/2023
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