Provider Demographics
NPI:1417198524
Name:MENDOZA, MARIA ARELLANO (DNP,FNP-C,APRN)
Entity Type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:ARELLANO
Last Name:MENDOZA
Suffix:
Gender:F
Credentials:DNP,FNP-C,APRN
Other - Prefix:DR
Other - First Name:MARIA
Other - Middle Name:ARELLANO
Other - Last Name:MENDOZA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DNP
Mailing Address - Street 1:385 CALLE DE ALEGRA STE A
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88005-3423
Mailing Address - Country:US
Mailing Address - Phone:575-526-1105
Mailing Address - Fax:575-524-4266
Practice Address - Street 1:575 S ALAMEDA BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2818
Practice Address - Country:US
Practice Address - Phone:575-449-0000
Practice Address - Fax:575-449-4021
Is Sole Proprietor?:No
Enumeration Date:2009-03-19
Last Update Date:2022-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX709128363LF0000X
NMCNP-03608363LF0000X, 363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX203995001Medicaid
8L12696Medicare PIN