Provider Demographics
NPI:1659049609
Name:PADILLA, CRISTINA ALICIA (NP)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:ALICIA
Last Name:PADILLA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2267 TRAWOOD DR STE G2
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79935-3027
Mailing Address - Country:US
Mailing Address - Phone:915-256-9751
Mailing Address - Fax:915-974-2344
Practice Address - Street 1:2267 TRAWOOD DR STE G2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-3027
Practice Address - Country:US
Practice Address - Phone:915-256-9751
Practice Address - Fax:915-974-2344
Is Sole Proprietor?:No
Enumeration Date:2021-09-03
Last Update Date:2021-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1033411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX758144OtherREGISTERED NURSE RN
TXAP1033411OtherNURSE PRACTITIONER APRN-CNP