Provider Demographics
NPI:1124881974
Name:REYES, ROSA ESMERALDA (MSN FNP BC)
Entity type:Individual
Prefix:MS
First Name:ROSA
Middle Name:ESMERALDA
Last Name:REYES
Suffix:
Gender:F
Credentials:MSN FNP BC
Other - Prefix:MRS
Other - First Name:ROSA
Other - Middle Name:ESMERALDA
Other - Last Name:VILLARREAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSN FNP BC
Mailing Address - Street 1:2337 ENDEAVOR STE A
Mailing Address - Street 2:
Mailing Address - City:LAREDO
Mailing Address - State:TX
Mailing Address - Zip Code:78041-1972
Mailing Address - Country:US
Mailing Address - Phone:956-726-4929
Mailing Address - Fax:956-724-6242
Practice Address - Street 1:2337 ENDEAVOR STE A
Practice Address - Street 2:
Practice Address - City:LAREDO
Practice Address - State:TX
Practice Address - Zip Code:78041-1972
Practice Address - Country:US
Practice Address - Phone:956-726-4929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-05
Last Update Date:2024-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX2023165841363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily