Provider Demographics
NPI:1184048597
Name:PAREDES, BEATRIZ ADRIANA (PA)
Entity type:Individual
Prefix:
First Name:BEATRIZ
Middle Name:ADRIANA
Last Name:PAREDES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:BEATRIZ
Other - Middle Name:ADRIANA
Other - Last Name:VELARDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 370
Mailing Address - Street 2:
Mailing Address - City:HATCH
Mailing Address - State:NM
Mailing Address - Zip Code:87937-0370
Mailing Address - Country:US
Mailing Address - Phone:575-267-3280
Mailing Address - Fax:575-267-1747
Practice Address - Street 1:125 CHAPARREL BLVD NW
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-8629
Practice Address - Country:US
Practice Address - Phone:575-546-4800
Practice Address - Fax:575-546-0685
Is Sole Proprietor?:No
Enumeration Date:2014-02-06
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2319363A00000X, 363AM0700X, 363AS0400X
NMPA2016-0040363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical