Individual
DR. TANYA VERONICA MARIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, CPNP-PC/A
Contact information
Practice address
1245 COUNTRY CLUB RD, SUITE 200, SANTA TERESA, NM 88008-9743
(575) 332-4633
(575) 332-4635
Mailing address
6241 SNOWHEIGHTS CT, EL PASO, TX 79912-3801
(915) 740-4344
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
644173
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP-02627
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
42850002
—
NM
01
—
644173
NURSE PRACTITIONERS
TX
Enumeration date
07/26/2006
Last updated
05/22/2019
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