Provider Demographics
NPI:1528561701
Name:SUAREZ, PATRICIA D (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:D
Last Name:SUAREZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18093 FM 2115
Mailing Address - Street 2:
Mailing Address - City:SALADO
Mailing Address - State:TX
Mailing Address - Zip Code:76571-6115
Mailing Address - Country:US
Mailing Address - Phone:361-648-9704
Mailing Address - Fax:
Practice Address - Street 1:CENTRAL CONSOLIDATED SCHOOL OF NEW MEXICO
Practice Address - Street 2:HWY 64, OLD HIGH SCHOOL ROAD
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420
Practice Address - Country:US
Practice Address - Phone:505-368-4984
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-14
Last Update Date:2018-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM89173163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WS0200XNursing Service ProvidersRegistered NurseSchoolGroup - Single Specialty