Healthcare Provider Details

I. General information

NPI: 1114377611
Provider Name (Legal Business Name): LOURDES ERICA CARDENAS APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/15/2016
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 HILLCREST DR STE A
VERNON TX
76384-3165
US

IV. Provider business mailing address

1015 HILLCREST DR STE A
VERNON TX
76384-3165
US

V. Phone/Fax

Practice location:
  • Phone: 940-552-5495
  • Fax: 940-552-2473
Mailing address:
  • Phone: 940-552-5495
  • Fax: 940-552-2473

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License NumberAP130985
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAG0416007 AANCP
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP130985
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: