Provider Demographics
NPI:1457630618
Name:CUELLAR, CAROLINA (CDE RN)
Entity Type:Individual
Prefix:MS
First Name:CAROLINA
Middle Name:
Last Name:CUELLAR
Suffix:
Gender:F
Credentials:CDE RN
Other - Prefix:
Other - First Name:CAROLINA
Other - Middle Name:
Other - Last Name:FLORES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6880
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87502-6880
Mailing Address - Country:US
Mailing Address - Phone:505-395-2288
Mailing Address - Fax:505-983-8135
Practice Address - Street 1:1035 ALTO ST
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501-2406
Practice Address - Country:US
Practice Address - Phone:505-982-4425
Practice Address - Fax:505-982-8440
Is Sole Proprietor?:No
Enumeration Date:2011-08-05
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR58316163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator