Provider Demographics
NPI:1790002830
Name:RAMIREZ, JOSE LUIS (APRN, CRNA-NSPM-C)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:LUIS
Last Name:RAMIREZ
Suffix:
Gender:M
Credentials:APRN, CRNA-NSPM-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 HILLRISE DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4703
Mailing Address - Country:US
Mailing Address - Phone:575-525-3980
Mailing Address - Fax:575-523-8660
Practice Address - Street 1:3005 HILLRISE DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4703
Practice Address - Country:US
Practice Address - Phone:575-525-3980
Practice Address - Fax:575-523-8660
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-29
Last Update Date:2024-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM01074367500000X
TXAP121846367500000X
NMCRNA-01074208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified RegisteredGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXAP121846OtherTEXAS LICENSE NUMBER
NMCRNA-01074OtherAPRN-CRNA