Provider Demographics
NPI:1619347374
Name:YVEN, PAMELA (CFNP)
Entity Type:Individual
Prefix:MRS
First Name:PAMELA
Middle Name:
Last Name:YVEN
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 168
Mailing Address - Street 2:
Mailing Address - City:ARROYO SECO
Mailing Address - State:NM
Mailing Address - Zip Code:87514-0168
Mailing Address - Country:US
Mailing Address - Phone:575-613-0441
Mailing Address - Fax:575-758-4903
Practice Address - Street 1:1399 WEIMER RD
Practice Address - Street 2:SUITE 200
Practice Address - City:TAOS
Practice Address - State:NM
Practice Address - Zip Code:87571-6340
Practice Address - Country:US
Practice Address - Phone:575-758-2224
Practice Address - Fax:575-758-4903
Is Sole Proprietor?:No
Enumeration Date:2015-10-06
Last Update Date:2016-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02779363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily