Individual provider · Type 1 NPI
Ivan Young Park, APRN
Acute Care Nurse Practitioner · Austin, TX
NPI number
1154076099
Active
Practice location
1208 W 38th St
Austin, TX 78705-1006
Mailing address
9811 Oak Run Dr
Austin, TX 78758-5545
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Acute Care Nurse Practitioner Primary | 363LA2100X | AP1072471 (TX) |
Acute Care Nurse Practitioner: Definition to come...
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About NPI 1154076099
Ivan Young Park, APRN's National Provider Identifier is 1154076099, issued on Feb 18, 2022. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Austin, TX. The record was last updated on Mar 17, 2022.