Provider Demographics
NPI:1467758755
Name:ENRIQUEZ, KARLA G (ACNP-BC)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:G
Last Name:ENRIQUEZ
Suffix:
Gender:F
Credentials:ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1574 CAMINO RUSTICA SW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-8114
Mailing Address - Country:US
Mailing Address - Phone:505-804-6934
Mailing Address - Fax:
Practice Address - Street 1:1574 CAMINO RUSTICA SW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-8114
Practice Address - Country:US
Practice Address - Phone:505-804-6934
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-03
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01737363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care