MEDICARE: URIEL NARSES MARTINEZ CAMPOS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	172V00000X	Community Health Worker	G-1372	NM

General Provider Information

NPI Number	:	1790580710
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	URIEL NARSES MARTINEZ CAMPOS

Provider Business Mailing Address
First Line	:	1190 S SAINT FRANCIS DR
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4173
Country	:	US
Telephone Number	:	575-882-3121
Fax Number	:	575-405-5472

Provider Business Practice Location Address
First Line	:	1190 S SAINT FRANCIS DR
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87505-4173
Country	:	US
Telephone Number	:	575-882-3121
Fax Number	:	575-405-5472

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/14/2025
Last Update Date	:	03/24/2026

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