Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | AP112871 | TX |
NPI | 1013095538 |
---|---|
Provider Name | Christina Estrellita Blanco |
First Address | El Paso, TX 79936-6011 |
Second Address | Santa Teresa, NM 88008-9743 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/11/2006 |
Last Update Date | 08/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
74039318 | (05) | NM |
Q59151 | (02) | TX |