Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363L00000X | Nurse Practitioner | ARNP2742702 | FL |
N | 363L00000X | Nurse Practitioner | CNP-03146 | NM |
Y | 363LP2300X | Nurse Practitioner - Primary Care | CNP-03146 | NM |
NPI | 1023105632 |
---|---|
Provider Name | Baudilio Jose' Velez |
First Address | Albuquerque, NM 87125-6028 |
Second Address | Albuquerque, NM 87109-5900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/10/2006 |
Last Update Date | 13/03/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
13835220 | (05) | NM |
30797088 | (05) | FL |
P00657716 | MEDICARE RR (01) | FL |