MEDICARE: MS. CELIA RACHEL BRACKNER ANP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	671744	TX

General Provider Information

NPI Number	:	1184981763
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CELIA RACHEL BRACKNER ANP

Provider Business Mailing Address
First Line	:	7333 NORTH FWY STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1346
Country	:	US
Telephone Number	:	713-691-3649
Fax Number	:	713-697-4006

Provider Business Practice Location Address
First Line	:	7333 NORTH FWY STE 100
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77076-1346
Country	:	US
Telephone Number	:	713-691-3649
Fax Number	:	713-697-4006

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/19/2012
Last Update Date	:	04/19/2012

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