Provider Demographics
NPI:1932862679
Name:BOTERO, SHARLEEN (FNP-C)
Entity Type:Individual
Prefix:
First Name:SHARLEEN
Middle Name:
Last Name:BOTERO
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 1:15310 TURNING TREE WAY
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-4663
Mailing Address - Country:US
Mailing Address - Phone:832-768-3251
Mailing Address - Fax:
Practice Address - Street 1:15310 TURNING TREE WAY
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-4663
Practice Address - Country:US
Practice Address - Phone:832-768-3251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-19
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1056777363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily