Provider Demographics
NPI:1477025690
Name:SANCHEZ, VICTOR (REGISTERED NURSE)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:M
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 MCNUTT RD
Mailing Address - Street 2:
Mailing Address - City:SUNLAND PARK
Mailing Address - State:NM
Mailing Address - Zip Code:88063-9056
Mailing Address - Country:US
Mailing Address - Phone:575-915-1338
Mailing Address - Fax:575-915-1819
Practice Address - Street 1:3465 MCNUTT RD
Practice Address - Street 2:
Practice Address - City:SUNLAND PARK
Practice Address - State:NM
Practice Address - Zip Code:88063-9056
Practice Address - Country:US
Practice Address - Phone:575-915-1338
Practice Address - Fax:575-915-1819
Is Sole Proprietor?:No
Enumeration Date:2018-12-28
Last Update Date:2018-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-88717163WC0400X, 163WD0400X, 163WG0000X, 163WP0000X, 163WP0200X, 163WP0807X, 163WP0808X, 163WP0809X, 163WR0400X, 163WW0000X, 163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WP0000XNursing Service ProvidersRegistered NursePain Management
No163WP0200XNursing Service ProvidersRegistered NursePediatrics
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
No163WR0400XNursing Service ProvidersRegistered NurseRehabilitation
No163WW0000XNursing Service ProvidersRegistered NurseWound Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NMPENDINGMedicaid