Healthcare Provider Details

I. General information

NPI: 1235065202
Provider Name (Legal Business Name): DENISE WAYE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5345 WYOMING BLVD NE STE 105
ALBUQUERQUE NM
87109-3193
US

IV. Provider business mailing address

5345 WYOMING BLVD NE STE 105
ALBUQUERQUE NM
87109-3193
US

V. Phone/Fax

Practice location:
  • Phone: 505-463-4174
  • Fax:
Mailing address:
  • Phone: 505-463-4174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416A0800X
TaxonomyAir Ambulance
License NumberR37341
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: