Provider Demographics
NPI:1891182192
Name:FUENTES, MIRIAM PAULA (MSN-FNP-C)
Entity Type:Individual
Prefix:MS
First Name:MIRIAM
Middle Name:PAULA
Last Name:FUENTES
Suffix:
Gender:F
Credentials:MSN-FNP-C
Other - Prefix:
Other - First Name:MIRIAM
Other - Middle Name:PAULA
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3022 TRAWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-4329
Mailing Address - Country:US
Mailing Address - Phone:915-855-8550
Mailing Address - Fax:915-603-4282
Practice Address - Street 1:3022 TRAWOOD
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938
Practice Address - Country:US
Practice Address - Phone:915-855-8550
Practice Address - Fax:915-603-0428
Is Sole Proprietor?:No
Enumeration Date:2015-04-24
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP128024363LF0000X, 364SF0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SF0001XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistFamily Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily