Individual
MRS. JESSICA ANN BURTON-VIGIL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2247 CALLE CACIQUE, SANTA FE, NM 87505-4944
(719) 351-6025
Mailing address
2247 CALLE CACIQUE, SANTA FE, NM 87505-4944
(719) 351-6025
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
APN.0990494-CRNA
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04035054
—
CO
05
—
1376840736
—
UT
05
—
16834542
—
CO
05
—
601718
—
AZ
05
—
74659065
—
NM
01
—
P00971956
RR MEDICARE PTAN
NM
01
—
P01126137
MEDICARE RAILROAD
CO
Enumeration date
02/22/2011
Last updated
10/04/2013
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