Provider Demographics
NPI:1063924751
Name:BURRELL-MIRAMONTES, CANDACE C (RN, FNP-C)
Entity type:Individual
Prefix:
First Name:CANDACE
Middle Name:C
Last Name:BURRELL-MIRAMONTES
Suffix:
Gender:F
Credentials:RN, FNP-C
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Other - First Name:
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Mailing Address - Street 1:3110 NOGALITOS STE 105
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78225-2337
Mailing Address - Country:US
Mailing Address - Phone:210-533-0257
Mailing Address - Fax:210-531-9488
Practice Address - Street 1:9811 HUEBNER RD BLDG 2
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78240-3255
Practice Address - Country:US
Practice Address - Phone:210-533-0257
Practice Address - Fax:210-534-0890
Is Sole Proprietor?:No
Enumeration Date:2017-11-02
Last Update Date:2023-04-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP135543363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP135543OtherTEXAS BOARD OF NURSING