MEDICARE: MS. EMILY D. CERRETA NP-C

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	546547	TX

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00924646	OTHER	TX	MEDICARE RAILROAD

Other Identifiers

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

General Provider Information

NPI Number	:	1700863909
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. EMILY D. CERRETA NP-C

Provider Business Mailing Address
First Line	:	4601 PARK RD
Second Line	:	SUITE 300
City	:	CHARLOTTE
State	:	NC
Zip	:	28209-3239
Country	:	US
Telephone Number	:	704-323-2000
Fax Number	:

Provider Business Practice Location Address
First Line	:	10496 KATY FWY
Second Line	:	SUITE 101
City	:	HOUSTON
State	:	TX
Zip	:	77043-5106
Country	:	US
Telephone Number	:	704-323-2000
Fax Number	:

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

Provider Enumeration Date	:	12/28/2005
Last Update Date	:	11/09/2016

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