Healthcare Provider Details

I. General information

NPI: 1326683202
Provider Name (Legal Business Name): ANA CARLA MENA APRN, PNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2019
Last Update Date: 01/19/2024
Certification Date: 01/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10470 VISTA DEL SOL DR STE 100
EL PASO TX
79925-7928
US

IV. Provider business mailing address

10470 VISTA DEL SOL DR STE 100
EL PASO TX
79925-7928
US

V. Phone/Fax

Practice location:
  • Phone: 915-615-7150
  • Fax:
Mailing address:
  • Phone: 915-615-7005
  • Fax: 855-618-2437

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP144029
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: