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NPI Code Detail

MEDICARE: MS. LORENA AIDE BURILLO APRN-CNP

MEDICARE:  MS. LORENA AIDE BURILLO  APRN-CNP
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
1363LW0102XWomen's Health Nurse Practitioner599995TX

General Provider Information

NPI Number : 1548290307
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LORENA AIDE BURILLO APRN-CNP
Provider Business Mailing Address
First Line : 13001 EASTLAKE BLVD STE 114
Second Line :
City : HORIZON CITY
State : TX
Zip : 79928-6312
Country : US
Telephone Number : 915-591-4624
Fax Number :
Provider Business Practice Location Address
First Line : 13001 EASTLAKE BLVD STE 114
Second Line :
City : HORIZON CITY
State : TX
Zip : 79928-6312
Country : US
Telephone Number : 915-591-4624
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/04/2006
Last Update Date : 02/10/2022

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Directions to “ MS. LORENA AIDE BURILLO APRN-CNP” Practice Location

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