Provider Demographics
NPI:1568024339
Name:MERCADO, INNA VILLANUEVA (MSN, RN, NP, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:INNA
Middle Name:VILLANUEVA
Last Name:MERCADO
Suffix:
Gender:F
Credentials:MSN, RN, NP, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 RICHMOND AVE
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77006-5419
Mailing Address - Country:US
Mailing Address - Phone:832-283-2490
Mailing Address - Fax:
Practice Address - Street 1:1003 RICHMOND AVE
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77006-5419
Practice Address - Country:US
Practice Address - Phone:713-807-8491
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP95010781363LF0000X
TXAP145893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily