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Individual

DEANNA KAY MALICOAT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNS

Contact information

Practice address
6010 BALCONES DR, STE. 102, AUSTIN, TX 78731-4270
(512) 323-5362
Mailing address
6010 BALCONES DR, STE. 102, AUSTIN, TX 78731-4270
(512) 323-5362

Taxonomy

Speciality
Code
Description
License number
State
364SA2200X
Adult Health Clinical Nurse Specialist
640904
TX
364SA2200X
Adult Health Clinical Nurse Specialist
Primary
AP116729
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
197820703
TX
Enumeration date
02/28/2008
Last updated
11/19/2014
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