Healthcare Provider Details

I. General information

NPI: 1861692766
Provider Name (Legal Business Name): ALACE L. ANAYA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2007
Last Update Date: 05/07/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

SLEEP DISORDER CTR 1101 MED. ARTS, BLD 2
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

THE UNIVERSITY OF NEW MEXICO MSC10 5550- 1 UNIV. OF NM ALB., NM 87131-0001
ALBUQUERQUE NM
87131-0001
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-6110
  • Fax: 505-272-6112
Mailing address:
  • Phone: 505-272-6110
  • Fax: 505-272-6112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR31330
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: