MEDICARE: BLANCA VARGAS 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
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	APN.0104125-C-NP	CO
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	CNP01486	NM

General Provider Information

NPI Number	:	1982060612
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BLANCA VARGAS CNP

Provider Business Mailing Address
First Line	:	385 CALLE DE ALEGRA STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3423
Country	:	US
Telephone Number	:	575-526-1105
Fax Number	:	575-524-4266

Provider Business Practice Location Address
First Line	:	3850 FOOTHILLS RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4632
Country	:	US
Telephone Number	:	866-228-7828
Fax Number	:

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

Provider Enumeration Date	:	01/11/2016
Last Update Date	:	08/04/2025

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