Provider Demographics
NPI:1093178766
Name:SANCHEZ, JAIME (AGACNP)
Entity Type:Individual
Prefix:MR
First Name:JAIME
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:AGACNP
Other - Prefix:MR
Other - First Name:JAIME
Other - Middle Name:
Other - Last Name:SANCHEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:AGACNP
Mailing Address - Street 1:8175 CONSTITUTION RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88007-8984
Mailing Address - Country:US
Mailing Address - Phone:575-303-2929
Mailing Address - Fax:
Practice Address - Street 1:8175 CONSTITUTION RD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88007-8984
Practice Address - Country:US
Practice Address - Phone:575-303-2929
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02883363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily