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General NPI Number Information
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NPI Number | 1386150076
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Entity Type | Individual
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Provider Name | RAIZA STEPHANIE MENA CRNA
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Gender | Female
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Dates
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Enumeration Date | 12/18/2017
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Last Update Date | 07/17/2025
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Provider Practice Location Address
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Address Line | 2400 UNSER BLVD SE
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City | RIO RANCHO
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State | NM
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Zip | 87124-3392
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Country | US
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Telephone | 505-253-7878
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Fax |
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Provider Business Mailing Address
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Address Line | 4101 INDIAN SCHOOL RD NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87110-3991
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Country | US
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Telephone |
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | CNP-03492
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 80409
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN-85664
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License Number State | NM
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