Individual
MRS. PAMELA ANNE MCNITZKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NNP
Contact information
Practice address
1221 NORTH MOPAC EXPRESSWAY, AUSTIN, TX 78708
(512) 901-2900
Mailing address
57 WOLFETON WAY, SAN ANTONIO, TX 78218-6034
(210) 826-1439
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
456833
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
096179907
—
TX
01
—
096179908
CSHCN
TX
01
—
18218001
MEDICAID/THSTEPS
TX
05
—
96179901
—
TX
Enumeration date
08/04/2006
Last updated
03/12/2014
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