MEDICARE: GRAYCE COWLES ZAYAS RN, BSN

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	163WS0200X	School Registered Nurse	74742	NM

General Provider Information

NPI Number	:	1881376267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRAYCE COWLES ZAYAS RN, BSN

Provider Business Mailing Address
First Line	:	4321 CALLE GUILLERMO
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-7740
Country	:	US
Telephone Number	:	505-930-3181
Fax Number	:

Provider Business Practice Location Address
First Line	:	2921 CAMINO DE LOS CABALLOS
Second Line	:
City	:	SANTA FE
State	:	NM
Zip	:	87507-9494
Country	:	US
Telephone Number	:	505-467-1600
Fax Number	:

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

Provider Enumeration Date	:	08/03/2023
Last Update Date	:	05/21/2024

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