Healthcare Provider Details

I. General information

NPI: 1447713342
Provider Name (Legal Business Name): JULIE RUBY ESQUIBEL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/09/2019
Last Update Date: 04/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3695 HOT SPRINGS BLVD
LAS VEGAS NM
87701-9549
US

IV. Provider business mailing address

3695 HOT SPRINGS BLVD
LAS VEGAS NM
87701-9549
US

V. Phone/Fax

Practice location:
  • Phone: 505-454-2100
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WG0000X
TaxonomyGeneral Practice Registered Nurse
License NumberRN-75767
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: