Provider Demographics
NPI:1467297333
Name:BENDER, MICHELLE DAWN (APRN FNP-C)
Entity type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:DAWN
Last Name:BENDER
Suffix:
Gender:F
Credentials:APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8328 MONTOYA CIR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78717-5452
Mailing Address - Country:US
Mailing Address - Phone:512-699-6580
Mailing Address - Fax:
Practice Address - Street 1:4910 MUELLER BLVD STE 102
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78723-3079
Practice Address - Country:US
Practice Address - Phone:512-777-2917
Practice Address - Fax:833-374-0023
Is Sole Proprietor?:No
Enumeration Date:2024-07-01
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1170162363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily