Individual
MARISA ANAYA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
420 N CORONADO AVE, ESPANOLA, NM 87532
(505) 753-2256
Mailing address
405 HUNTER ST, ESPANOLA, NM 87532-2656
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
86586
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
34659714
—
NM
Enumeration date
10/15/2018
Last updated
10/15/2018
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