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NPI Code Detail

MEDICARE: MS. BERNADETTE ETOAMA PMHNP-BC

MEDICARE:  MS. BERNADETTE  ETOAMA  PMHNP-BC
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
1364SP0809XAdult Psychiatric/Mental Health Clinical Nurse Specialist1034068TX

Other Identifiers

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

General Provider Information

NPI Number : 1730201187
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. BERNADETTE ETOAMA PMHNP-BC
Provider Business Mailing Address
First Line : 5500 GUHN RD STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77040-6162
Country : US
Telephone Number : 713-783-8889
Fax Number : 713-953-0471
Provider Business Practice Location Address
First Line : 5500 GUHN RD STE 100
Second Line :
City : HOUSTON
State : TX
Zip : 77040-6162
Country : US
Telephone Number : 713-783-8889
Fax Number : 713-953-0471
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/05/2007
Last Update Date : 07/06/2022

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Directions to “ MS. BERNADETTE ETOAMA PMHNP-BC” Practice Location

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