MEDICARE: SCARLETT MARIE NERIOS NP

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	363L00000X	Nurse Practitioner	1059102	TX

General Provider Information

NPI Number	:	1467119040
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCARLETT MARIE NERIOS NP

Provider Business Mailing Address
First Line	:	9701 HARMON RD STE 141
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-7602
Country	:	US
Telephone Number	:	817-306-5630
Fax Number	:	817-306-5631

Provider Business Practice Location Address
First Line	:	9701 HARMON RD STE 141
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76177-7602
Country	:	US
Telephone Number	:	817-306-5630
Fax Number	:	817-306-5631

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

Provider Enumeration Date	:	11/18/2021
Last Update Date	:	11/18/2021

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