Provider Demographics
NPI:1013646181
Name:GALAZ, DENISE EDITH (FNP-C)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:EDITH
Last Name:GALAZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 GALAZ ST
Mailing Address - Street 2:
Mailing Address - City:SAN LORENZO
Mailing Address - State:NM
Mailing Address - Zip Code:88041-7508
Mailing Address - Country:US
Mailing Address - Phone:575-936-0936
Mailing Address - Fax:
Practice Address - Street 1:1280 E 32ND ST
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-7229
Practice Address - Country:US
Practice Address - Phone:575-388-1561
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-06
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM68302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily