Healthcare Provider Details

I. General information

NPI: 1891603486
Provider Name (Legal Business Name): JUNALUZ BARADAS NP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20728 LAURA LEE LN
PORTER TX
77365-7216
US

IV. Provider business mailing address

20728 LAURA LEE LN
PORTER TX
77365-7216
US

V. Phone/Fax

Practice location:
  • Phone: 217-721-7161
  • Fax:
Mailing address:
  • Phone: 217-721-7161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SC0200X
TaxonomyCritical Care Medicine Clinical Nurse Specialist
License Number1231399
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: