Provider Demographics
NPI:1669002564
Name:SIFUENTES, NADIA IVETH (FNP)
Entity Type:Individual
Prefix:
First Name:NADIA
Middle Name:IVETH
Last Name:SIFUENTES
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 1:139 VILLAGE EAST DR
Mailing Address - Street 2:
Mailing Address - City:LOS FRESNOS
Mailing Address - State:TX
Mailing Address - Zip Code:78566-3104
Mailing Address - Country:US
Mailing Address - Phone:956-459-4251
Mailing Address - Fax:
Practice Address - Street 1:800 W JEFFERSON ST STE 200
Practice Address - Street 2:
Practice Address - City:BROWNSVILLE
Practice Address - State:TX
Practice Address - Zip Code:78520-6300
Practice Address - Country:US
Practice Address - Phone:956-574-0431
Practice Address - Fax:956-541-1011
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-19
Last Update Date:2020-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP145039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily