Provider Demographics
NPI:1740742048
Name:QUIROZ, ABIGAIL CANAVA (FNP)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CANAVA
Last Name:QUIROZ
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 1:715 UNDERWOOD ST
Mailing Address - Street 2:
Mailing Address - City:KERMIT
Mailing Address - State:TX
Mailing Address - Zip Code:79745-4520
Mailing Address - Country:US
Mailing Address - Phone:432-586-2712
Mailing Address - Fax:
Practice Address - Street 1:828 MYER LN
Practice Address - Street 2:
Practice Address - City:KERMIT
Practice Address - State:TX
Practice Address - Zip Code:79745-4634
Practice Address - Country:US
Practice Address - Phone:432-586-2040
Practice Address - Fax:432-586-9136
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP138358363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily