Healthcare Provider Details

I. General information

NPI: 1740832989
Provider Name (Legal Business Name): ARIA SANDERS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/09/2019
Last Update Date: 03/01/2024
Certification Date: 03/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

912 1ST ST NW
ALBUQUERQUE NM
87102-2355
US

IV. Provider business mailing address

912 1ST ST NW
ALBUQUERQUE NM
87102-2355
US

V. Phone/Fax

Practice location:
  • Phone: 505-224-9777
  • Fax: 505-747-7396
Mailing address:
  • Phone: 505-224-9777
  • Fax: 505-747-7396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberCNP-56738
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: