Individual
JOSHUA ENRIQUE FANTAUZZI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
4225 WOODS PL, ABILENE, TX 79602-7991
(325) 691-0030
Mailing address
4225 WOODS PL, ABILENE, TX 79602-7991
(325) 691-0030
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
946772
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1180710
TX
Other
Enumeration date
11/18/2024
Last updated
12/02/2024
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