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General NPI Number Information
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NPI Number | 1740767177
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Entity Type | Individual
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Provider Name | ISAACC GUILLERMO NINO APRN, FNP-BC
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Gender | Male
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Dates
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Enumeration Date | 07/27/2018
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Last Update Date | 12/13/2021
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Provider Practice Location Address
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Address Line | 3804 S. JACKSON RD., STE. #1
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City | EDINBURG
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State | TX
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Zip | 78539-6101
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Country | US
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Telephone | 956-296-3001
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Fax | 956-396-3000
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Provider Business Mailing Address
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Address Line | 602 COFFEE MILL DR
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City | EDINBURG
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State | TX
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Zip | 78541-1310
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Country | US
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Telephone | 956-878-2160
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 736520
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP138261
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP138261
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License Number State | TX
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