Individual
SALLY B PLOURDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
6425 S IH 35 STE 100, AUSTIN, TX 78744-4230
(512) 744-6000
(512) 225-6520
Mailing address
9411 N LAMAR BLVD STE 120, AUSTIN, TX 78753-4179
(512) 583-9679
(512) 233-0985
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
541988
TX
364SP0200X
Pediatric Clinical Nurse Specialist
Primary
AP121376
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3280315-02
—
TX
Enumeration date
10/19/2012
Last updated
04/19/2016
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