Provider Demographics
NPI:1215486568
Name:FERNANDEZ, REBECCA TARANGO (APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:TARANGO
Last Name:FERNANDEZ
Suffix:
Gender:F
Credentials:APRN, FNP-C
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Mailing Address - Street 1:PO BOX 1470
Mailing Address - Street 2:
Mailing Address - City:EAGLE PASS
Mailing Address - State:TX
Mailing Address - Zip Code:78853-1470
Mailing Address - Country:US
Mailing Address - Phone:830-773-8917
Mailing Address - Fax:830-773-1892
Practice Address - Street 1:119 E ACADEMY ST
Practice Address - Street 2:
Practice Address - City:DEL RIO
Practice Address - State:TX
Practice Address - Zip Code:78840-6072
Practice Address - Country:US
Practice Address - Phone:830-422-3305
Practice Address - Fax:855-458-3317
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-28
Last Update Date:2023-11-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP132079363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXF0916385OtherAMERICAN ACADEMY OF NURSE PRATITIONERS
TX3706871-01Medicaid