Juanita Sena

Individual provider Active NPI Registered Nurse · Isleta, NM

NPI 1720229362 · NPPES record last updated Mar 11, 2009

Key facts

NPI
1720229362
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R12755 (NM)
Practice address
01 Sagebrush Road
Isleta, NM 87022-0580
Phone
(505) 869-3200
Fax
(505) 869-4584
NPI assigned
Mar 11, 2009
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R12755NMMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Pueblo of Isleta Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R12755 NM Yes

Addresses

Primary practice location

01 Sagebrush Road
Isleta, NM 87022-0580

Mailing address

01 Sagebrush Road
Isleta, NM 87022-0580
Phone (505) 869-3200

Other identifiers

IdentifierTypeStateIssuer
1194738328OtherNATIONAL PROVIDER NUMBER
308522081MedicaidNM

Other providers in Isleta, NM

All providers in Isleta, NM · Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.