Provider Demographics
NPI:1902295215
Name:PENA HUMAN, LYNDA (CPNP, PHMNP)
Entity Type:Individual
Prefix:MRS
First Name:LYNDA
Middle Name:
Last Name:PENA HUMAN
Suffix:
Gender:F
Credentials:CPNP, PHMNP
Other - Prefix:MRS
Other - First Name:LYNDA
Other - Middle Name:
Other - Last Name:HUMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CPNP, PMHNP-BC
Mailing Address - Street 1:PO BOX 972733
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79997-2733
Mailing Address - Country:US
Mailing Address - Phone:999-999-9999
Mailing Address - Fax:
Practice Address - Street 1:8500 BOEING DR
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-1224
Practice Address - Country:US
Practice Address - Phone:915-599-6600
Practice Address - Fax:915-629-2680
Is Sole Proprietor?:No
Enumeration Date:2015-01-10
Last Update Date:2024-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX757699163W00000X
TXAP127048363LP0200X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics