Healthcare Provider Details
I. General information
NPI: 1477025690
Provider Name (Legal Business Name): VICTOR SANCHEZ REGISTERED NURSE
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/28/2018
Last Update Date: 12/28/2018
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3465 MCNUTT RD
SUNLAND PARK NM
88063-9056
US
IV. Provider business mailing address
3465 MCNUTT RD
SUNLAND PARK NM
88063-9056
US
V. Phone/Fax
- Phone: 575-915-1338
- Fax: 575-915-1819
- Phone: 575-915-1338
- Fax: 575-915-1819
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WD0400X |
| Taxonomy | Diabetes Educator Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0000X |
| Taxonomy | Pain Management Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0200X |
| Taxonomy | Pediatric Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0807X |
| Taxonomy | Child & Adolescent Psychiatric/Mental Health Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0808X |
| Taxonomy | Psychiatric/Mental Health Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WP0809X |
| Taxonomy | Adult Psychiatric/Mental Health Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 9 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WR0400X |
| Taxonomy | Rehabilitation Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WW0000X |
| Taxonomy | Wound Care Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
| # 11 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN-88717 |
| License Number State | NM |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
