CEREBRO LLC NPI 1336619329

NPI Information

NPI: 1336619329
Provider Name: CEREBRO LLC
Classification: Nurse Practitioner - 363LP0808X
Specialization: Psychiatric/Mental Health
Entity Type: Organization
Address: 307 E 1ST ST STE 10-4
PROSPER, TX
ZIP 75078
Phone: (903) 946-1261

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NPI Details

CEREBRO LLC is a psychiatric/mental health nurse practitioner in Prosper, TX. CEREBRO LLC NPI is 1336619329. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

307 E 1ST ST STE 10-4
PROSPER, TX
ZIP 75078-973
Phone: (903) 946-1261

The provider's authorized official is Pamela R Evans .
The authorized official title is Owner/provider and has the following contact phone number (903) 946-1261.

The enumeration date for this NPI number is 12/3/2018 and was last updated on 12/13/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0808X	Nurse Practitioner	Psychiatric/Mental Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	AP139190	OTHER	TEXAS	STATE ADVANCED PRACTICE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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