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NPI Code Detail

MEDICARE: GRISELDA BERMUDEZ REGISTERED NURSE

MEDICARE: GRISELDA BERMUDEZ REGISTERED NURSE
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
1163WC0400XCase Management Registered Nurse699065TX

General Provider Information

NPI Number : 1538975412
Entity Type Code : Individual
Provider Name (Legal Business Name) : GRISELDA BERMUDEZ REGISTERED NURSE
Provider Business Mailing Address
First Line : 313 7TH ST
Second Line :
City : ANTHONY
State : TX
Zip : 79821-7129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11335 SSG SIMS ST
Second Line :
City : FORT BLISS
State : TX
Zip : 79918-8033
Country : US
Telephone Number : 915-742-6090
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/05/2024
Last Update Date : 02/05/2025

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Directions to “ GRISELDA BERMUDEZ REGISTERED NURSE” Practice Location

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