Provider Demographics
NPI:1902059454
Name:VELJI, GLENDA MAXINE CAROL (RN, FNP-C)
Entity Type:Individual
Prefix:MS
First Name:GLENDA
Middle Name:MAXINE CAROL
Last Name:VELJI
Suffix:
Gender:F
Credentials:RN, FNP-C
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Mailing Address - Street 1:PO BOX 13442
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78711-3442
Mailing Address - Country:US
Mailing Address - Phone:512-323-5465
Mailing Address - Fax:512-327-1390
Practice Address - Street 1:5656 BEE CAVES RD BLDG C # 101
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78746
Practice Address - Country:US
Practice Address - Phone:512-323-5465
Practice Address - Fax:512-327-1390
Is Sole Proprietor?:No
Enumeration Date:2008-10-28
Last Update Date:2020-02-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXAP117026363LF0000X, 208M00000X
TX593219363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXTXB164045OtherMEDICARE
TX2045973-03Medicaid