Healthcare Provider Details

I. General information

NPI: 1194229138
Provider Name (Legal Business Name): ANA M GARCIA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2018
Last Update Date: 03/23/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 ALTO VISTA DR
SUNLAND PARK NM
88063-9116
US

IV. Provider business mailing address

PO DRAWER 70
ANTHONY NM
88021
US

V. Phone/Fax

Practice location:
  • Phone: 575-589-1676
  • Fax:
Mailing address:
  • Phone: 575-882-6101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number918185
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: