Healthcare Provider Details

I. General information

NPI: 1336624006
Provider Name (Legal Business Name): YVETTE CISNEROS APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: YVETTE CISNEROS RODRIGUEZ APRN-CNP

II. Dates (important events)

Enumeration Date: 09/28/2018
Last Update Date: 09/28/2023
Certification Date: 09/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1901 S 24TH AVE
EDINBURG TX
78539-6533
US

IV. Provider business mailing address

1901 S 24TH AVE
EDINBURG TX
78539-6533
US

V. Phone/Fax

Practice location:
  • Phone: 956-289-7000
  • Fax: 956-289-7257
Mailing address:
  • Phone: 956-289-7000
  • Fax: 956-289-7257

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP138961
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: