Vergara-Blake, Judith M
Vergara-Blake, Judith M is an individual health care provider with primary practice located at 1500 Walter St Se , Albuquerque NM 87102-4658. She recently has only one registered license in Nursing Service Providers / Women's Health Care, Ambulatory, which is considered as her primary health care specialty. Vergara-Blake, Judith M can be contacted via phone (505) 272-1393.Contact Information
Primary practice address
1500 Walter St Se
Albuquerque NM 87102-4658
Phone: (505) 272-1393
Fax: (505) 272-2177
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Women's Health Care, Ambulatory | 163WW0101X | R51480 | New Mexico |
Profile Details
| NPI number | 1730169699 |
|---|---|
| LBN Legal business name | Vergara-Blake, Judith M |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 18th, 2006 |
| Last updated | Jul 5th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1730169699 | NPPES |
| New Mexico | MEDICAID | 75502330 |
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