Provider Demographics
NPI:1447763651
Name:VIGIL-SANCHEZ, REINA (RN)
Entity Type:Individual
Prefix:
First Name:REINA
Middle Name:
Last Name:VIGIL-SANCHEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:CHIMAYO
Mailing Address - State:NM
Mailing Address - Zip Code:87522-0435
Mailing Address - Country:US
Mailing Address - Phone:505-367-3420
Mailing Address - Fax:505-753-6177
Practice Address - Street 1:1111 EL LLANO RD
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-6727
Practice Address - Country:US
Practice Address - Phone:505-367-3420
Practice Address - Fax:505-753-6177
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-09
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR49972163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool