1538223771 NPI number — MISS MARY P SAIZ WHCNP

Table of content: MISS MARY P SAIZ WHCNP (NPI 1538223771)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538223771 NPI number — MISS MARY P SAIZ WHCNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAIZ
Provider First Name:
MARY
Provider Middle Name:
P
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
WHCNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SAIZ
Provider Other First Name:
MARY
Provider Other Middle Name:
PRUDENCE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
WHCNP-BC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1538223771
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1600 NORTH MAIN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LOVINGTON
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
88260-2830
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
575-396-6611
Provider Business Mailing Address Fax Number:
575-396-1454

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1600 NORTH MAIN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LOVINGTON
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
88260-2830
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
575-396-6611
Provider Business Practice Location Address Fax Number:
575-396-1454
Provider Enumeration Date:
12/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LW0102X , with the licence number:  573502 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: CNP00669 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 509510YNGG . This is a "PTAN" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: NM006J89 . This is a "BCBS" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 25658522 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com