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General NPI Number Information
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NPI Number | 1508525486
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Entity Type | Organization
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Legal Business Name | VOLCANO VISTA PSYCHIATRY & WELLNESS LLC
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Dates
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Enumeration Date | 12/08/2021
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Last Update Date | 12/08/2021
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Provider Practice Location Address
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Address Line | 140 JUNIPER RD
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City | PLACITAS
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State | NM
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Zip | 87043-9123
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Country | US
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Telephone | 505-404-9364
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 561
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City | PLACITAS
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State | NM
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Zip | 87043-0561
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Country | US
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Telephone | 505-404-9364
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Fax |
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Authorized Official
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Title or Position | PSYCHIATRIC NURSE PRACTITIONER
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Name | DR. ESTHER DENISE VERZI
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Credential | CNP, DNP, PMHNP-BC
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Telephone | 505-404-9364
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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