Provider Demographics
NPI:1629842414
Name:BARRERA, PAIGE ALLYSE (MSN, PMHNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:PAIGE
Middle Name:ALLYSE
Last Name:BARRERA
Suffix:
Gender:F
Credentials:MSN, PMHNP-BC
Other - Prefix:MS
Other - First Name:PAIGE
Other - Middle Name:ALLYSE
Other - Last Name:WASHINGTON AND BARRERA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN, RN, BSN
Mailing Address - Street 1:14845 WILLIAM MESHEL DR
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79938-4898
Mailing Address - Country:US
Mailing Address - Phone:915-422-2066
Mailing Address - Fax:
Practice Address - Street 1:5065 MCNUTT RD
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9442
Practice Address - Country:US
Practice Address - Phone:575-589-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-13
Last Update Date:2023-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1136640363LP0808X
NM76436363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health