Organization
RENEW PSYCHIATRIC ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANASTASIA CORKER PMHNP (OWNER)
(512) 876-7037
Entity
Organization
Contact information
Practice address
12701 W STATE HIGHWAY 29 STE 5, LIBERTY HILL, TX 78642-6348
(512) 548-5373
(512) 548-5374
Mailing address
12701 W STATE HIGHWAY 29 STE 5, LIBERTY HILL, TX 78642-6348
(512) 548-5373
(512) 548-5374
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558701565
NPI
TX
Enumeration date
04/17/2019
Last updated
03/23/2021
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