Provider Demographics
NPI:1184255770
Name:PLATA, BERNICE CASTANEDA (FNP-C)
Entity type:Individual
Prefix:
First Name:BERNICE
Middle Name:CASTANEDA
Last Name:PLATA
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 1:2270 JOE BATTLE BLVD STE O
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-2610
Mailing Address - Country:US
Mailing Address - Phone:915-856-7000
Mailing Address - Fax:
Practice Address - Street 1:2270 JOE BATTLE BLVD STE O
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2610
Practice Address - Country:US
Practice Address - Phone:915-856-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-01
Last Update Date:2020-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP144161363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily