MEDICARE: MS. CERENA H. SUAREZ FNP

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	363LF0000X	Family Nurse Practitioner	AP102703	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	287654YLPS	OTHER	TX	WELLMED PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1356345037
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CERENA H. SUAREZ FNP

Provider Business Mailing Address
First Line	:	7430 REMCON CIR
Second Line	:	BLDG A
City	:	EL PASO
State	:	TX
Zip	:	79912-3514
Country	:	US
Telephone Number	:	915-584-0051
Fax Number	:	915-833-1114

Provider Business Practice Location Address
First Line	:	7430 REMCON CIR
Second Line	:	BLDG A
City	:	EL PASO
State	:	TX
Zip	:	79912-3514
Country	:	US
Telephone Number	:	915-584-0051
Fax Number	:	915-833-1114

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	10/16/2015

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