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NPI Code Detail

MEDICARE: ELENA A. OLIVAS CNP

MEDICARE: ELENA A. OLIVAS CNP
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
1363LW0102XWomen's Health Nurse PractitionerR28404NM

General Provider Information

NPI Number : 1841329992
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELENA A. OLIVAS CNP
Provider Business Mailing Address
First Line : PO BOX 734
Second Line :
City : MESQUITE
State : NM
Zip : 88048-0734
Country : US
Telephone Number : 505-635-7336
Fax Number :
Provider Business Practice Location Address
First Line : 865 N MAIN
Second Line :
City : ANTHONY
State : NM
Zip : 88021-9325
Country : US
Telephone Number : 505-882-7552
Fax Number : 505-882-3063
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2007
Last Update Date : 07/08/2007

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