Provider Demographics
NPI:1306738471
Name:ATZGER-JOHN, TRICIA L (RN)
Entity type:Individual
Prefix:
First Name:TRICIA
Middle Name:L
Last Name:ATZGER-JOHN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 PLAZA PL
Mailing Address - Street 2:STE 300, PMB 2004
Mailing Address - City:NORTHLAKE
Mailing Address - State:TX
Mailing Address - Zip Code:76226
Mailing Address - Country:US
Mailing Address - Phone:817-381-5157
Mailing Address - Fax:
Practice Address - Street 1:10431 GENTRY DR
Practice Address - Street 2:
Practice Address - City:JUSTIN
Practice Address - State:TX
Practice Address - Zip Code:76247-7890
Practice Address - Country:US
Practice Address - Phone:817-368-4399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171400000X
TX608034163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No171400000XOther Service ProvidersHealth & Wellness Coach