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General NPI Number Information
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NPI Number | 1932430501
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Entity Type | Individual
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Provider Name | ANITA VELASCO ACNP
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Gender | Female
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Dates
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Enumeration Date | 01/21/2010
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Last Update Date | 10/15/2021
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Provider Practice Location Address
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Address Line | 4208 CENTRAL AVE SW STE G
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City | ALBUQUERQUE
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State | NM
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Zip | 87105-1695
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Country | US
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Telephone | 505-777-3001
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Fax | 505-808-4977
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Provider Business Mailing Address
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Address Line | PO BOX 740018
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City | ATLANTA
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State | GA
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Zip | 30374-0018
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Country | US
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Telephone | 312-773-9730
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Fax | 773-866-8014
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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 | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | R31406
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 01587
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | CNP01587
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License Number State | NM
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