NPI Code Details Logo

NPI 1578911368

NPI 1578911368 : MARREN ONYALO NP : LAS CRUCES, NM

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1578911368
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    MARREN ONYALO NP
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/02/2016
-----------------------------------------------------
    Last Update Date     |    03/07/2024
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    205 W. BOUTZ RD BLDG 8, STE 1
-----------------------------------------------------
    City                 |    LAS CRUCES
-----------------------------------------------------
    State                |    NM
-----------------------------------------------------
    Zip                  |    88005-1766
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    575-521-4555
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    205 W. BOUTZ RD BLDG 8, STE 1
-----------------------------------------------------
    City                 |    LAS CRUCES
-----------------------------------------------------
    State                |    NM
-----------------------------------------------------
    Zip                  |    88005
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    575-521-4555
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LP0808X
-----------------------------------------------------
    Taxonomy Name        |    Psychiatric/Mental Health Nurse Practitioner
-----------------------------------------------------
    License Number       |    CNP-03038
-----------------------------------------------------
    License Number State |    NM
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    CNP-03038
-----------------------------------------------------
    License Number State |    NM
-----------------------------------------------------



                        

Copyright © 2007-2026 Data Labs Health. All rights reserved.