Healthcare Provider Details

I. General information

NPI: 1972856276
Provider Name (Legal Business Name): PATRICIA MARGARET VERZINO CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2012
Last Update Date: 10/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

433 SAINT MICHAELS DR
SANTA FE NM
87505-7601
US

IV. Provider business mailing address

996 CAMINO RIZO
SANTA FE NM
87505-5251
US

V. Phone/Fax

Practice location:
  • Phone: 505-988-1232
  • Fax:
Mailing address:
  • Phone: 619-994-0018
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-02044
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: