Provider Demographics
NPI:1790786044
Name:HURTADO, CHERYL L (ACNS-BC)
Entity Type:Individual
Prefix:
First Name:CHERYL
Middle Name:L
Last Name:HURTADO
Suffix:
Gender:F
Credentials:ACNS-BC
Other - Prefix:
Other - First Name:CHERYL
Other - Middle Name:
Other - Last Name:WINDSTIEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ACNS-BC
Mailing Address - Street 1:900 W. 38TH STREET, SUITE 110
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705
Mailing Address - Country:US
Mailing Address - Phone:512-421-3869
Mailing Address - Fax:512-407-1873
Practice Address - Street 1:900 W. 38TH STREET, SUITE 110
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705
Practice Address - Country:US
Practice Address - Phone:512-421-3869
Practice Address - Fax:512-407-1873
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2022-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX630423207RC0000X, 364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87NOtherBC BS
TX06006617ZOtherRAILROAD MEDICARE
TX1639189-01Medicaid
TX85N027Medicare PIN
TX1639189-01Medicaid
TX8G5108Medicare PIN