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General NPI Number Information
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NPI Number | 1194687681
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Entity Type | Organization
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Legal Business Name | NEXUS VITALITY CENTER
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Dates
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Enumeration Date | 12/02/2025
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Last Update Date | 12/09/2025
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Provider Practice Location Address
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Address Line | 6001 MENAUL BLVD NE # 1107
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3379
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Country | US
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Telephone | 702-945-8262
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Fax |
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Provider Business Mailing Address
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Address Line | 6001 MENAUL BLVD NE # 1107
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3379
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Country | US
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Telephone | 702-945-8262
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Fax |
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL
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Name | SAMMY NZIVO
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Credential |
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Telephone | 702-945-8262
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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