Provider Demographics
NPI:1720574213
Name:ALDAZ, PATRICIA J (CNP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:ALDAZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1401 S COUNTRY CLUB CIR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220-4121
Mailing Address - Country:US
Mailing Address - Phone:575-361-2889
Mailing Address - Fax:
Practice Address - Street 1:2013 SAN JOSE BLVD
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220-5426
Practice Address - Country:US
Practice Address - Phone:575-887-2455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-08
Last Update Date:2019-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM53287363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily