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Individual

MRS. TESSA NICOLE MAULDIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MS, APRN, AGNP-C

Contact information

Practice address
5040 KINSEY DR STE 300, TYLER, TX 75703-3046
(903) 561-8300
Mailing address
205 TULLY TRL, WHITEHOUSE, TX 75791-3131

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP134542
TX
363LA2200X
Adult Health Nurse Practitioner
Primary
AP134542
TX
363LG0600X
Gerontology Nurse Practitioner
AP134542
TX
363LP2300X
Primary Care Nurse Practitioner
AP134542
TX

Other

Enumeration date
07/18/2017
Last updated
07/13/2022
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