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General NPI Number Information
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NPI Number | 1295707743
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Entity Type | Individual
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Provider Name | VICENTA CUNTAPAY ANQUE FNP
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Gender | Female
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Dates
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Enumeration Date | 02/07/2006
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Last Update Date | 09/05/2012
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Provider Practice Location Address
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Address Line | 1166 K ST
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City | BRAWLEY
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State | CA
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Zip | 92227-2737
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Country | US
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Telephone | 760-344-9951
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Fax | 760-344-1629
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Provider Business Mailing Address
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Address Line | 223 W COLE BLVD
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City | CALEXICO
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State | CA
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Zip | 92231-9722
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Country | US
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Telephone | 760-357-2020
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Fax | 760-357-1056
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 345872
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163WG0000X
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Taxonomy Name | General Practice Registered Nurse
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License Number | 12183
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License Number State | CA
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