Provider Demographics
NPI:1477305522
Name:HERRERA, ROSA ISELA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ROSA
Middle Name:ISELA
Last Name:HERRERA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2023 FOXBOROUGH
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78852-4392
Mailing Address - Country:US
Mailing Address - Phone:830-776-3906
Mailing Address - Fax:
Practice Address - Street 1:2023 FOXBOROUGH
Practice Address - Street 2:
Practice Address - City:EAGLE PASS
Practice Address - State:TX
Practice Address - Zip Code:78852-4392
Practice Address - Country:US
Practice Address - Phone:830-776-3906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1156099363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily