Provider Demographics
NPI:1013041110
Name:ESPAILLAT, FERMINA AMARILIS (CNS-WHNP)
Entity Type:Individual
Prefix:MRS
First Name:FERMINA
Middle Name:AMARILIS
Last Name:ESPAILLAT
Suffix:
Gender:F
Credentials:CNS-WHNP
Other - Prefix:
Other - First Name:FERMINA
Other - Middle Name:AMARILIS
Other - Last Name:ESPAILLAT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CNS-WHNP
Mailing Address - Street 1:3102 MINTHORN DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-1932
Mailing Address - Country:US
Mailing Address - Phone:254-554-3347
Mailing Address - Fax:
Practice Address - Street 1:108 E HALSTEAD AVE
Practice Address - Street 2:SUITE A
Practice Address - City:COPPERAS COVE
Practice Address - State:TX
Practice Address - Zip Code:76522-1825
Practice Address - Country:US
Practice Address - Phone:254-547-4673
Practice Address - Fax:254-547-7653
Is Sole Proprietor?:No
Enumeration Date:2007-03-14
Last Update Date:2016-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX628558364SW0102X, 163WW0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SW0102XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistWomen's Health
No163WW0101XNursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory