Provider Demographics
NPI:1497717078
Name:SANCHEZ, KRISTINA N (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:N
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:N
Other - Last Name:VANDENBOSCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 91224
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87199-1224
Mailing Address - Country:US
Mailing Address - Phone:505-924-5840
Mailing Address - Fax:505-924-5841
Practice Address - Street 1:4600B MONTGOMERY BLVD NE
Practice Address - Street 2:STE 100
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87109
Practice Address - Country:US
Practice Address - Phone:505-924-5840
Practice Address - Fax:505-924-5841
Is Sole Proprietor?:No
Enumeration Date:2006-04-06
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43226202K00000X
TXP9455202K00000X
NMMD2014-0808202K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes202K00000XAllopathic & Osteopathic PhysiciansPhlebology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO12603775Medicaid
CO12603775Medicaid
CO803299Medicare ID - Type Unspecified