Provider Demographics
NPI:1225338262
Name:VASQUEZ, MONICA S (FNP)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:S
Last Name:VASQUEZ
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 N KANSAS ST
Mailing Address - Street 2:STE. 1501
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79901-1443
Mailing Address - Country:US
Mailing Address - Phone:915-546-9200
Mailing Address - Fax:915-546-9800
Practice Address - Street 1:221 N KANSAS ST
Practice Address - Street 2:STE. 1501
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79901-1443
Practice Address - Country:US
Practice Address - Phone:915-546-9200
Practice Address - Fax:915-546-9800
Is Sole Proprietor?:No
Enumeration Date:2010-10-25
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP119761363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX2194730-02Medicaid
TX8483NDOtherBC/BS OF TEXAS
TXP01249694OtherRAILROAD RETIREMENT MEDICARE
TX8483NDOtherBC/BS OF TEXAS