Provider Demographics
NPI:1215621370
Name:BRUNO-OLIVAREZ, JANIE (FNP)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:
Last Name:BRUNO-OLIVAREZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W 1ST ST
Mailing Address - Street 2:
Mailing Address - City:MERCEDES
Mailing Address - State:TX
Mailing Address - Zip Code:78570-2551
Mailing Address - Country:US
Mailing Address - Phone:956-565-3191
Mailing Address - Fax:956-565-5485
Practice Address - Street 1:1500 W 1ST ST
Practice Address - Street 2:
Practice Address - City:MERCEDES
Practice Address - State:TX
Practice Address - Zip Code:78570-2551
Practice Address - Country:US
Practice Address - Phone:956-565-3191
Practice Address - Fax:956-565-6485
Is Sole Proprietor?:No
Enumeration Date:2023-06-02
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1053411363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily