Avalon Santana Zakazakina, RN

Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Mescalero, NM

NPI 1609683697 · NPPES record last updated Dec 13, 2024

Key facts

NPI
1609683697
Entity type
Individual (NPI type 1)
Primary specialty
Psychiatric/Mental Health Registered Nurse 163WP0808X
License
76328 (NM)
Practice address
454 Lipan Avenue
Mescalero, NM 88340
Phone
(575) 464-4802
NPI assigned
Dec 13, 2024
Sex
Female
Sole proprietor
Yes

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

LicenseStateTypeSpecialty
76328NMMDPsychiatric/Mental Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Registered Nurse 163WP0808X 76328 NM Yes

Addresses

Primary practice location

454 Lipan Avenue
Mescalero, NM 88340

Mailing address

82 Pioneer Dr
Timberon, NM 88350-9678
Phone (575) 987-2209

Other providers in Mescalero, NM

All providers in Mescalero, NM · Psychiatric/Mental Health Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.