MEDICARE: NANCY BARRAZA FNP

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	F07221895	TX

General Provider Information

NPI Number	:	1790496917
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NANCY BARRAZA FNP

Provider Business Mailing Address
First Line	:	9740 DYER ST STE 111&112
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-4752
Country	:	US
Telephone Number	:	915-500-5030
Fax Number	:	915-500-5001

Provider Business Practice Location Address
First Line	:	9740 DYER ST STE 111&112
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79924-4752
Country	:	US
Telephone Number	:	915-500-5030
Fax Number	:	915-500-5001

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

Provider Enumeration Date	:	12/08/2022
Last Update Date	:	12/08/2022

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