Provider Information for 1104428416
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Mr. ERNESTO MARRERO MSN, FNP
Sex: Male
NPI: 1104428416
Last Updated: 2023-09-29
Certification Date: 2023-09-29
Certification Date: 2023-09-29
Details
| Name | Value | ||||||||
|---|---|---|---|---|---|---|---|---|---|
| NPI | 1104428416 | ||||||||
| Enumeration Date | 2020-11-11 | ||||||||
| NPI Type | NPI-1 Individual | ||||||||
| Sole Proprietor | YES | ||||||||
| Status | Active | ||||||||
| Mailing Address | 2631 GATTIS SCHOOL RD STE 150 ROUND ROCK, TX 78664-2825 United States Phone: 512-243-5872 | Fax:512-243-7130 | ||||||||
| Primary Practice Address | 2631 GATTIS SCHOOL RD STE 150 ROUND ROCK, TX 78664-2825 United States Phone: 512-243-5872 | Fax:512-243-7130 | ||||||||
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