Provider Demographics
NPI:1013429570
Name:REYNA, ROXANA (FNP-C)
Entity Type:Individual
Prefix:
First Name:ROXANA
Middle Name:
Last Name:REYNA
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4455 S PADRE ISLAND DR STE 13
Mailing Address - Street 2:
Mailing Address - City:CORPUS CHRISTI
Mailing Address - State:TX
Mailing Address - Zip Code:78411-5161
Mailing Address - Country:US
Mailing Address - Phone:361-226-8226
Mailing Address - Fax:830-632-6568
Practice Address - Street 1:4455 S PADRE ISLAND DR STE 13
Practice Address - Street 2:
Practice Address - City:CORPUS CHRISTI
Practice Address - State:TX
Practice Address - Zip Code:78411-5161
Practice Address - Country:US
Practice Address - Phone:361-248-2663
Practice Address - Fax:361-356-7420
Is Sole Proprietor?:No
Enumeration Date:2017-10-24
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX658246163W00000X
TXAP134121363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse