Itasca Healing Medical Practice
Itasca Healing Medical Practice is a Nurse Practitioner in Nacogdoches, Texas. Registered with an NPI since 2024.
- In the registry since
- 2024
Practice location Address checks out
223 King StNacogdoches, TX 75961-4421
Phone: (936) 622-0552
Fax: (936) 622-0554
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Nurse Practitioner (primary) | Taxonomy 363L00000X |
|---|
Record details
| NPI number | 1023867546 |
|---|---|
| Entity type | Organization (Type 2) |
| Organization subpart | No |
| Authorized official | Suzanna Fuller — Owner/ Provider · (936) 622-0552 |
| NPI enumerated | May 16, 2024 |
| Last updated in NPPES | August 5, 2026 |
| Certification date | August 5, 2026 |
| Mailing address | 223 King St, Nacogdoches, TX 75961-4421 |
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