MEDICARE: MRS. ALBA GRACIELA SIERRA-PEREZ DNP, APRN, WHNP-BC

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	363LW0102X	Women's Health Nurse Practitioner	45843	KS
2	363LW0102X	Women's Health Nurse Practitioner	774056	TX
3	363LW0102X	Women's Health Nurse Practitioner	151817	MO

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	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1467419119
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ALBA GRACIELA SIERRA-PEREZ DNP, APRN, WHNP-BC

Provider Business Mailing Address
First Line	:	1355 CENTRAL PKWY S
Second Line	:	STE 400
City	:	SAN ANTONIO
State	:	TX
Zip	:	78232-5057
Country	:	US
Telephone Number	:	210-349-9300
Fax Number	:	210-366-2558

Provider Business Practice Location Address
First Line	:	1303 MCCULLOUGH AVE
Second Line	:	STE GL70
City	:	SAN ANTONIO
State	:	TX
Zip	:	78212-5631
Country	:	US
Telephone Number	:	210-226-9705
Fax Number	:	210-223-4555

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	09/08/2017

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