Provider Demographics
NPI:1164494704
Name:SANCHEZ, MICHAEL (CRNA)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7788 JEFFERSON ST NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87109-4342
Mailing Address - Country:US
Mailing Address - Phone:505-999-1600
Mailing Address - Fax:
Practice Address - Street 1:7788 JEFFERSON ST NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109-4342
Practice Address - Country:US
Practice Address - Phone:505-999-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR28434367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM10013983OtherLOVELACE HEALTH/SALUD
AZ861460Medicaid
NM75683Medicaid
NM201046552OtherPRESBYTERIAN HEALTH/SALUD
850313268001OtherCHAMPUS
NMQMYPR0067314OtherMOLINA
NMQMYPR0067314OtherMOLINA