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NPI Code Detail

MEDICARE: FERNANDA CALIENES CERPA MD

MEDICARE: FERNANDA CALIENES CERPA MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
2207P00000XEmergency Medicine Physician2025-01037NC

General Provider Information

NPI Number : 1295485324
Entity Type Code : Individual
Provider Name (Legal Business Name) : FERNANDA CALIENES CERPA MD
Provider Business Mailing Address
First Line : 7920 DENSMORE AVE N
Second Line :
City : SEATTLE
State : WA
Zip : 98103-4910
Country : US
Telephone Number : 928-965-3969
Fax Number :
Provider Business Practice Location Address
First Line : 1000 BLYTHE BLVD
Second Line :
City : CHARLOTTE
State : NC
Zip : 28203-5812
Country : US
Telephone Number : 704-355-2000
Fax Number : 704-355-7047
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2022
Last Update Date : 06/09/2026

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