Provider Demographics
NPI:1326330101
Name:PUENTE, ROSALBA E (FNP)
Entity Type:Individual
Prefix:
First Name:ROSALBA
Middle Name:E
Last Name:PUENTE
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1010 JAMES ST STE B
Mailing Address - Street 2:
Mailing Address - City:WESLACO
Mailing Address - State:TX
Mailing Address - Zip Code:78596-6654
Mailing Address - Country:US
Mailing Address - Phone:956-968-1621
Mailing Address - Fax:
Practice Address - Street 1:1010 JAMES ST STE B
Practice Address - Street 2:
Practice Address - City:WESLACO
Practice Address - State:TX
Practice Address - Zip Code:78596-6654
Practice Address - Country:US
Practice Address - Phone:956-968-1621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-11
Last Update Date:2011-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX675401163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX675401OtherFAMILY NURSE PRACTITIONER