Individual
VANESSA V CASAREZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNNP
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4930
(505) 841-1090
(505) 222-2371
Mailing address
5901 HARPER DR NE, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87109-3587
(505) 823-8528
(505) 823-8555
Taxonomy
Speciality
Code
Description
License number
State
363LN0000X
Neonatal Nurse Practitioner
Primary
R48516
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
NM
Enumeration date
06/19/2006
Last updated
07/08/2007
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