Healthcare Provider Details

I. General information

NPI: 1629498688
Provider Name (Legal Business Name): EMANUEL ARROYO FNP-BC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/17/2014
Last Update Date: 06/30/2020
Certification Date: 06/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3817 CONSTITUTION DR STE 200
EL PASO TX
79922-1368
US

IV. Provider business mailing address

3817 CONSTITUTION DR STE 200
EL PASO TX
79922-1368
US

V. Phone/Fax

Practice location:
  • Phone: 915-999-9999
  • Fax:
Mailing address:
  • Phone: 915-999-9999
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number800096
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP137255
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: