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Individual

JAVIER VELASCO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
117 E 19TH ST, ROSWELL, NM 88201-5151
(575) 627-7000
Mailing address
407 HERMOSA DR, ROSWELL, NM 88201-6536
(208) 569-4513

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
72015
NM
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
12/12/2022
Last updated
12/05/2024
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