Provider Demographics
NPI:1437314036
Name:BAEZA, CRISTINA TORRES (LVN)
Entity Type:Individual
Prefix:
First Name:CRISTINA
Middle Name:TORRES
Last Name:BAEZA
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1607 E 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ODESSA
Mailing Address - State:TX
Mailing Address - Zip Code:79761-2971
Mailing Address - Country:US
Mailing Address - Phone:432-272-5652
Mailing Address - Fax:432-272-5652
Practice Address - Street 1:1607 E 12TH ST
Practice Address - Street 2:
Practice Address - City:ODESSA
Practice Address - State:TX
Practice Address - Zip Code:79761-2971
Practice Address - Country:US
Practice Address - Phone:432-272-5652
Practice Address - Fax:432-272-5652
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-23
Last Update Date:2008-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX181344164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse