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General NPI Number Information
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NPI Number | 1104213354
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Entity Type | Individual
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Provider Name | CELIA ROSE YAZZIE APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 04/24/2015
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 7501 HOLLY AVE NE STE 21
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2629
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Country | US
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Telephone | 505-584-5537
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Fax |
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Provider Business Mailing Address
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Address Line | 7501 HOLLY AVE NE STE 21
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-2629
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Country | US
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Telephone | 505-584-5537
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | RN-75312
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 79258
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License Number State | NM
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