Provider Demographics
NPI:1073296950
Name:ESQUIVEL, ADRIAN (RN)
Entity Type:Individual
Prefix:
First Name:ADRIAN
Middle Name:
Last Name:ESQUIVEL
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:165 N COLLISON AVE
Mailing Address - Street 2:
Mailing Address - City:CIMARRON
Mailing Address - State:NM
Mailing Address - Zip Code:87714-8505
Mailing Address - Country:US
Mailing Address - Phone:575-377-6991
Mailing Address - Fax:
Practice Address - Street 1:165 N COLLISON AVE
Practice Address - Street 2:
Practice Address - City:CIMARRON
Practice Address - State:NM
Practice Address - Zip Code:87714-8505
Practice Address - Country:US
Practice Address - Phone:575-377-6991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-08
Last Update Date:2023-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM70739163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool