MEDICARE: MRS. MARIA MERCEDES ACEVEDO AGACNP

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	363LA2100X	Acute Care Nurse Practitioner	AP127315	TX
2	363LA2200X	Adult Health Nurse Practitioner	AP127315	TX
3	363LG0600X	Gerontology Nurse Practitioner	AP127315	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1184014391
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARIA MERCEDES ACEVEDO AGACNP

Provider Business Mailing Address
First Line	:	PO BOX 911230
Second Line	:
City	:	DALLAS
State	:	TX
Zip	:	75391-1230
Country	:	US
Telephone Number	:	972-997-8000
Fax Number	:	972-234-2987

Provider Business Practice Location Address
First Line	:	3270 JOE BATTLE BLVD STE 312
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79938-2651
Country	:	US
Telephone Number	:	915-747-4877
Fax Number	:	915-849-4255

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

Provider Enumeration Date	:	01/26/2015
Last Update Date	:	08/14/2023

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Directions to “ MRS. MARIA MERCEDES ACEVEDO AGACNP” Practice Location

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