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General NPI Number Information
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NPI Number | 1902621360
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Entity Type | Individual
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Provider Name | CYRENE MAY IBANEZ BAGAYAS REGISTERED NURSE
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Gender | Female
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Dates
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Enumeration Date | 11/20/2024
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Last Update Date | 11/20/2024
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Provider Practice Location Address
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Address Line | PO BOX 358
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City | CROWNPOINT
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State | NM
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Zip | 87313-0358
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Country | US
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Telephone | 505-786-5291
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Fax |
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Provider Business Mailing Address
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Address Line | 1102 S TABOR AVE APT 602
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City | NORTH PLATTE
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State | NE
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Zip | 69101-7765
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Country | US
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Telephone | 308-660-1470
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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 | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 92761
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License Number State | NE
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