Provider Demographics
NPI:1487162038
Name:ANDERSON, CAYCE (RN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:CAYCE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:CAYCE
Other - Middle Name:
Other - Last Name:GIBSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2901 MONTOPOLIS DR
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78741-6411
Mailing Address - Country:US
Mailing Address - Phone:512-978-9901
Mailing Address - Fax:
Practice Address - Street 1:2901 MONTOPOLIS DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78741-6411
Practice Address - Country:US
Practice Address - Phone:512-978-9901
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-17
Last Update Date:2020-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX815397163W00000X
TXAP135831363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX815397OtherTEXAS BOARD OF NURSING
TXAP135831OtherTEXAS BOARD OF NURSING