Individual provider Active NPI

Ana Lisa Quintero, MSN, APRN, FNP-BC

  • Family Nurse Practitioner
  • San Juan, TX
National Provider Identifier
1386045540
Registry record updated Apr 21, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
AP126194 Issued in TX
Practice address
1229 S Veterans Blvd
San Juan, TX 78589-3232
Phone
(956) 787-5454
Fax
(956) 787-5486
NPI assigned
Sep 8, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X AP126194 TX Primary

Addresses

Primary practice location

1229 S Veterans Blvd
San Juan, TX 78589-3232

Mailing address

1229 S Veterans Blvd
San Juan, TX 78589-3232
Phone (956) 787-5454

Other identifiers 1

IdentifierTypeStateIssuer
341017701MedicaidTX

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP126194TXMDFamily Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461196800000",
    "number": "1386045540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1229 S VETERANS BLVD",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893232",
            "telephone_number": "956-787-5454",
            "fax_number": "956-787-5486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1229 S VETERANS BLVD",
            "city": "SAN JUAN",
            "state": "TX",
            "postal_code": "785893232",
            "telephone_number": "956-787-5454",
            "fax_number": "956-787-5486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QUINTERO",
        "first_name": "ANA LISA",
        "credential": "MSN, APRN, FNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2016-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "AP126194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "341017701",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in San Juan, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.