Provider Demographics
NPI:1356983209
Name:VENEGAS, SYBILL RENEE (FNP-BC)
Entity type:Individual
Prefix:
First Name:SYBILL
Middle Name:RENEE
Last Name:VENEGAS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11688 TONY TEJEDA DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-6521
Mailing Address - Country:US
Mailing Address - Phone:954-274-8052
Mailing Address - Fax:915-533-8055
Practice Address - Street 1:3030 JOE BATTLE BLVD STE B
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79938-2668
Practice Address - Country:US
Practice Address - Phone:915-225-4470
Practice Address - Fax:915-533-8055
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-11
Last Update Date:2019-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP137089363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty