Provider Demographics
NPI:1053855304
Name:SAMILLANO, NANETTE
Entity Type:Individual
Prefix:
First Name:NANETTE
Middle Name:
Last Name:SAMILLANO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NANETTE
Other - Middle Name:PANAGUITON
Other - Last Name:SAMILLANO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSN, APRN, FNP-C
Mailing Address - Street 1:8311 N 22ND LN
Mailing Address - Street 2:
Mailing Address - City:MCALLEN
Mailing Address - State:TX
Mailing Address - Zip Code:78504-5733
Mailing Address - Country:US
Mailing Address - Phone:956-533-9623
Mailing Address - Fax:
Practice Address - Street 1:8311 N 22ND LN
Practice Address - Street 2:
Practice Address - City:MCALLEN
Practice Address - State:TX
Practice Address - Zip Code:78504-5733
Practice Address - Country:US
Practice Address - Phone:956-533-9623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX672710363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily