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NPI Code Detail

MEDICARE: DR. CURTISS JOHN VAVRA CNP, PHD, MSN

MEDICARE: DR. CURTISS JOHN VAVRA CNP, PHD, MSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR27383NM
2363LP2300XPrimary Care Nurse Practitioner84621NM
3363LG0600XGerontology Nurse Practitioner84621NM

General Provider Information

NPI Number : 1871359125
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CURTISS JOHN VAVRA CNP, PHD, MSN
Provider Business Mailing Address
First Line : 9628 VISTA CASITAS DR NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87114-3720
Country : US
Telephone Number : 505-301-1660
Fax Number : 505-209-2358
Provider Business Practice Location Address
First Line : 5901 OURAY RD NW
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87120-1381
Country : US
Telephone Number : 505-836-0023
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/26/2024
Last Update Date : 02/14/2026

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