Basic Information
| Provider Information | |||||||||
| NPI: | 1891756938 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | LERMA | ||||||||
| FirstName: | ANDREA | ||||||||
| MiddleName: | Y VALLE | ||||||||
| NamePrefix: | MS. | ||||||||
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| Credential: | APN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 E WISTERIA AVE | ||||||||
| Address2: | |||||||||
| City: | MCALLEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785042322 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9566180856 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1401 S RANGERVILLE RD | ||||||||
| Address2: | |||||||||
| City: | HARLINGEN | ||||||||
| State: | TX | ||||||||
| PostalCode: | 785527638 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9563648000 | ||||||||
| FaxNumber: | 9563648497 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/29/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0808X | 223034 | TX | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health |
No ID Information.