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Ivy Healthcare
Family Nurse Practitioner in Longview, Texas
NPI 1710585617

Ivy Healthcare is a Family Nurse Practitioner based in Longview, TX and is specialized in Family. Ivy Healthcare practices in Longview, TX. The NPI Number for Ivy Healthcare is 1710585617 and holds a License No. (Texas).

The current practice location address for Ivy Healthcare is 1100 N 4Th St, Longview, TX and can be reached out via phone at 903-918-8520 and via fax at 866-842-1649.

Location: 1100 N 4Th St, Longview, TX, 75608-6059
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1710585617
Provider Name
Ivy Healthcare
Credential
Provider Entity Type
Organization
Address
1100 N 4Th St, Longview, TX, 75608-6059
Phone Number
903-918-8520
Fax Number
866-842-1649
Provider Enumeration Date
10/13/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
AP140963 01 TX LICENSE TO PRACTICE
institution
Provider Business Practice Location Address Details
Address
1100 N 4Th St
City
Longview
State
Texas
Zip
75601-4739
Phone Number
903-918-8520
Fax Number
866-842-1649
person
Provider Business Mailing Address Details
Address
1100 N 4Th St
City
Longview
State
Texas
Zip
75601-4739
Phone Number
903-918-8520
Fax Number
866-842-1649
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
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Definition
Definition to come...
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