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NPI Code Detail

MEDICARE: LOURDES ERICA CARDENAS APRN

MEDICARE:   LOURDES ERICA CARDENAS  APRN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse PractitionerAP130985TX
2363L00000XNurse PractitionerAG0416007 AANCPTX
3363LA2200XAdult Health Nurse PractitionerAP130985TX
4363LG0600XGerontology Nurse PractitionerAP130985TX

General Provider Information

NPI Number : 1114377611
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOURDES ERICA CARDENAS APRN
Provider Business Mailing Address
First Line : 1015 HILLCREST DR
Second Line : STE A
City : VERNON
State : TX
Zip : 76384-3165
Country : US
Telephone Number : 940-552-5495
Fax Number : 940-552-2473
Provider Business Practice Location Address
First Line : 1015 HILLCREST DR
Second Line :
City : VERNON
State : TX
Zip : 76384-3100
Country : US
Telephone Number : 940-473-9043
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2016
Last Update Date : 09/23/2016

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Directions to “ LOURDES ERICA CARDENAS APRN” Practice Location

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