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NPI Code Detail

MEDICARE: ROSA JUAREZ NALLA

MEDICARE: ROSA JUAREZ NALLA
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
1363LA2100XAcute Care Nurse Practitioner1095949TX

General Provider Information

NPI Number : 1710613385
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROSA JUAREZ NALLA
Provider Business Mailing Address
First Line : PO BOX 610344
Second Line :
City : DALLAS
State : TX
Zip : 75261-0344
Country : US
Telephone Number : 254-245-9175
Fax Number : 254-213-7771
Provider Business Practice Location Address
First Line : 710 E 6TH ST
Second Line :
City : ODESSA
State : TX
Zip : 79761-4655
Country : US
Telephone Number : 254-245-9175
Fax Number : 254-213-7771
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/26/2022
Last Update Date : 01/12/2026

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Directions to “ ROSA JUAREZ NALLA ” Practice Location

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