Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 1019347 | TX |
NPI | 1023610458 |
---|---|
Provider Name | Charmaine Ann Enerio |
First Address | Webster, TX 77598-8538 |
Second Address | Webster, TX 77598-4841 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/11/2020 |
Last Update Date | 23/07/2021 |