Provider Demographics
NPI:1871036913
Name:HERMOSILLO, CATHALINE LILIAN (CPNP- PC)
Entity type:Individual
Prefix:MRS
First Name:CATHALINE
Middle Name:LILIAN
Last Name:HERMOSILLO
Suffix:
Gender:F
Credentials:CPNP- PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3657 MAYA LIZABETH PL
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4817
Mailing Address - Country:US
Mailing Address - Phone:915-240-0700
Mailing Address - Fax:
Practice Address - Street 1:1390 GEORGE DIETER DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79936-7420
Practice Address - Country:US
Practice Address - Phone:915-591-7704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-21
Last Update Date:2016-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132581363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics