Provider Demographics
NPI:1518463850
Name:ACEVEDO, CLAIRE LOUISE (MSN, RN, WHNP-BC)
Entity type:Individual
Prefix:
First Name:CLAIRE
Middle Name:LOUISE
Last Name:ACEVEDO
Suffix:
Gender:F
Credentials:MSN, RN, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:616 MACO DR
Mailing Address - Street 2:
Mailing Address - City:HARLINGEN
Mailing Address - State:TX
Mailing Address - Zip Code:78550-8450
Mailing Address - Country:US
Mailing Address - Phone:956-264-1600
Mailing Address - Fax:
Practice Address - Street 1:616 MACO DR
Practice Address - Street 2:
Practice Address - City:HARLINGEN
Practice Address - State:TX
Practice Address - Zip Code:78550-8450
Practice Address - Country:US
Practice Address - Phone:956-264-1600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2020-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137228363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1376868901Medicaid
TX1356304281Medicaid