Marisa Anaya, RN
Individual provider Active NPI Registered Nurse · Espanola, NM
NPI 1174099428 · NPPES record last updated Oct 15, 2018
Key facts
- NPI
- 1174099428
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Nurse 163W00000X
- License
- 86586 (NM)
- Practice address
- 420 N Coronado Ave
Espanola, NM 87532 - Phone
- (505) 753-2256
- NPI assigned
- Oct 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86586 | NM | MD | Registered Nurse |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Espanola Public Schools | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 86586 | NM | Yes |
Addresses
Primary practice location
420 N Coronado Ave
Espanola, NM 87532
Mailing address
405 Hunter St
Espanola, NM 87532-2656
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 34659714 | Medicaid | NM |
Other providers in Espanola, NM
- Francisca Nwamaka Alozie
- Mildred Altamira
- Erika Alvarado
- Ana M Guldan, Ma, LPCC, LLC
- Cruz Anaya
- Mark Andrew Angel
- Kristal Anguiano
- Beverly Archuleta
- Christina Archuleta
- Daniel Archuleta
All providers in Espanola, NM · Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2018. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.