Individual provider · Type 1 NPI
Trent J. Fackelman, FNP-C
Family Nurse Practitioner · San Antonio, TX
NPI number
1407466410
Active
Practice location
8500 Village Dr Ste 202
San Antonio, TX 78217-5510
Fax (210) 957-1697
Mailing address
2600 Kerri Strug Cv
Austin, TX 78748-2077
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Registered Nurse | 163W00000X | 816398 (TX) |
| Family Nurse Practitioner Primary | 363LF0000X | 1007822 (TX) |
Family Nurse Practitioner: Definition to come...
Another provider at this address
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About NPI 1407466410
Trent J. Fackelman, FNP-C's National Provider Identifier is 1407466410, issued on Aug 4, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Antonio, TX. The record was last updated on Sep 13, 2022.