Provider Demographics
NPI:1215256656
Name:CANTOS, YESSENIA (NP)
Entity type:Individual
Prefix:
First Name:YESSENIA
Middle Name:
Last Name:CANTOS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:ALICE
Mailing Address - State:TX
Mailing Address - Zip Code:78332-4822
Mailing Address - Country:US
Mailing Address - Phone:361-396-0370
Mailing Address - Fax:361-664-2248
Practice Address - Street 1:2808 INDUSTRIAL LOOP
Practice Address - Street 2:
Practice Address - City:BEEVILLE
Practice Address - State:TX
Practice Address - Zip Code:78102
Practice Address - Country:US
Practice Address - Phone:361-358-8411
Practice Address - Fax:361-362-0695
Is Sole Proprietor?:No
Enumeration Date:2010-05-25
Last Update Date:2015-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP 9194097163WC0400X, 163WH1000X, 163WP0000X
TX816686363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WH1000XNursing Service ProvidersRegistered NurseHospice
No163WP0000XNursing Service ProvidersRegistered NursePain Management