MEDICARE: MRS. RUTH ANN HERRERA R.N.,F.N.P.

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
1	363LF0000X	Family Nurse Practitioner	445717	TX

General Provider Information

NPI Number	:	1174525596
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. RUTH ANN HERRERA R.N.,F.N.P.

Provider Business Mailing Address
First Line	:	1405 BAYOU RD.
Second Line	:
City	:	GRAPEVINE
State	:	TX
Zip	:	76051
Country	:	US
Telephone Number	:	512-587-5736
Fax Number	:

Provider Business Practice Location Address
First Line	:	7000 WOODHUE DR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78745-5454
Country	:	US
Telephone Number	:	512-439-0701
Fax Number	:	512-439-0702

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/15/2005
Last Update Date	:	04/11/2013

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