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General NPI Number Information
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NPI Number | 1235530288
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Entity Type | Individual
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Provider Name | NATIVIDAD CARRILLO MSN, APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/09/2014
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Last Update Date | 10/06/2014
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Provider Practice Location Address
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Address Line | 1315 E 6TH ST
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City | WESLACO
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State | TX
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Zip | 78596-4200
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Country | US
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Telephone | 956-351-5949
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Fax | 956-351-5946
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Provider Business Mailing Address
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Address Line | 2917 MIDWAY RD
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City | WESLACO
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State | TX
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Zip | 78596-9406
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Country | US
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Telephone | 956-536-6966
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Fax | 956-377-5250
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP125897
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License Number State | TX
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