Individual
MR. JONATHAN WAKNINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MA, APRN, PMHNP-BC
Contact information
Practice address
1710 RED RIVER ST, AUSTIN, TX 78712-1918
(512) 471-7913
Mailing address
1710 RED RIVER ST, AUSTIN, TX 78712-1918
(512) 471-7913
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
1085727
TX
Other
Enumeration date
08/13/2024
Last updated
08/13/2024
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