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General NPI Number Information
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NPI Number | 1992405781
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Entity Type | Individual
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Provider Name | JANELLE MARIE VARGAS RN
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Gender | Female
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Dates
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Enumeration Date | 03/09/2023
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Last Update Date | 03/09/2023
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Provider Practice Location Address
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Address Line | 404 SAND STREET
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City | MILAN
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State | NM
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Zip | 87021
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Country | US
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Telephone | 505-285-2729
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Fax |
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Provider Business Mailing Address
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Address Line | 948 ELM DR
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City | GRANTS
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State | NM
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Zip | 87020-3008
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Country | US
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Telephone | 505-285-4580
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 59692
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License Number State | NM
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