Healthcare Provider Details

I. General information

NPI: 1053243295
Provider Name (Legal Business Name): NANCY SOSA APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/02/2026
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1245 COUNTRY CLUB RD STE 200
SANTA TERESA NM
88008-9743
US

IV. Provider business mailing address

3340 TIERRA ANGEL DR
EL PASO TX
79938-4826
US

V. Phone/Fax

Practice location:
  • Phone: 575-332-4633
  • Fax:
Mailing address:
  • Phone: 915-373-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1212553
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: