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General NPI Number Information
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NPI Number | 1952962391
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Entity Type | Individual
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Provider Name | NICOLE ANN ALANIZ AGACNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/26/2019
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Last Update Date | 03/03/2020
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Provider Practice Location Address
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Address Line | 4311 E LOHMAN AVE
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City | LAS CRUCES
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State | NM
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Zip | 88011-8255
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Country | US
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Telephone | 575-556-6740
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Fax |
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Provider Business Mailing Address
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Address Line | 4256 LYRA CT
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City | LAS CRUCES
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State | NM
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Zip | 88011-0946
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Country | US
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Telephone | 575-642-6970
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | RN-72848
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 57103
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License Number State | NM
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