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General NPI Number Information
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NPI Number | 1700257987
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Entity Type | Individual
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Provider Name | KEIRSTEN AYISA CUMMINGS APRN, FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/13/2015
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Last Update Date | 09/30/2020
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Provider Practice Location Address
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Address Line | 128 N FM 3167
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City | RIO GRANDE CITY
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State | TX
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Zip | 78582-6211
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Country | US
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Telephone | 956-735-3347
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Fax |
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Provider Business Mailing Address
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Address Line | 1705 PEBBLE DR
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City | MISSION
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State | TX
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Zip | 78574-2197
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Country | US
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Telephone | 956-735-3347
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Fax |
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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 | AP128897
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License Number State | TX
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