Healthcare Provider Details

I. General information

NPI: 1487048609
Provider Name (Legal Business Name): LORRAINE GLORIA SANCHEZ MSN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LORI GLORIA YU RN

II. Dates (important events)

Enumeration Date: 03/25/2015
Last Update Date: 08/05/2021
Certification Date: 08/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

755 S TELSHOR BLVD STE S102
LAS CRUCES NM
88011-4688
US

IV. Provider business mailing address

755 S TELSHOR BLVD STE S102
LAS CRUCES NM
88011-4688
US

V. Phone/Fax

Practice location:
  • Phone: 575-222-4355
  • Fax: 575-800-0344
Mailing address:
  • Phone: 575-222-4355
  • Fax: 575-800-0344

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-02609
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: