Provider Demographics
NPI:1508223975
Name:VIERRA, AMY
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:VIERRA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8913 CHERRY HILLS RD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1028
Mailing Address - Country:US
Mailing Address - Phone:505-470-3500
Mailing Address - Fax:
Practice Address - Street 1:8913 CHERRY HILLS RD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1028
Practice Address - Country:US
Practice Address - Phone:505-470-3500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-15
Last Update Date:2016-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist