Individual
AMY B SOUTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
403 STATE HIGHWAY 110 N, WHITEHOUSE, TX 75791-3109
(903) 839-1000
(903) 839-4000
Mailing address
13027 STATE HIGHWAY 155 S, TYLER, TX 75703-6548
(903) 839-1000
(903) 839-4000
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
712711
TX
363LF0000X
Family Nurse Practitioner
Primary
712711
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1881972727
BCBSTX
TX
01
—
1881972727
NPI
—
05
—
2867178-02
—
TX
01
—
8EM889
BCBSTX
TX
01
—
P01436333
RR MEDICARE
TX
Enumeration date
07/26/2011
Last updated
03/05/2019
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