Provider Demographics
NPI:1942917562
Name:TORRES CERVANTES, VERONICA (FNP-C)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:TORRES CERVANTES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 VINTON RD
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:NM
Mailing Address - Zip Code:88021-7047
Mailing Address - Country:US
Mailing Address - Phone:720-276-8251
Mailing Address - Fax:
Practice Address - Street 1:200 VINTON RD
Practice Address - Street 2:
Practice Address - City:ANTHONY
Practice Address - State:NM
Practice Address - Zip Code:88021-7047
Practice Address - Country:US
Practice Address - Phone:720-276-8251
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-11-02
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1105758363LF0000X
NM70740363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXMT7795036OtherDEA