MEDICARE: ELIZABETH BECERRA APRN, FNP-C

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	1056383	TX

General Provider Information

NPI Number	:	1457161655
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH BECERRA APRN, FNP-C

Provider Business Mailing Address
First Line	:	25714 HILL AND DALE AVE
Second Line	:
City	:	SPLENDORA
State	:	TX
Zip	:	77372-5348
Country	:	US
Telephone Number	:	323-392-4601
Fax Number	:

Provider Business Practice Location Address
First Line	:	21 ALPINE ST
Second Line	:
City	:	COLDSPRING
State	:	TX
Zip	:	77331-8058
Country	:	US
Telephone Number	:	936-647-2227
Fax Number	:

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

Provider Enumeration Date	:	01/09/2025
Last Update Date	:	01/09/2025

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