MEDICARE: AMY HERRERA CST CSFA

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	364SM0705X	Medical-Surgical Clinical Nurse Specialist	148588	TX

General Provider Information

NPI Number	:	1902212012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY HERRERA CST CSFA

Provider Business Mailing Address
First Line	:	1711 OLD SPANISH TRL APT 139
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1961
Country	:	US
Telephone Number	:	972-704-8496
Fax Number	:

Provider Business Practice Location Address
First Line	:	1711 OLD SPANISH TRL APT 139
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77054-1961
Country	:	US
Telephone Number	:	972-704-8496
Fax Number	:

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

Provider Enumeration Date	:	07/09/2014
Last Update Date	:	12/26/2024

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