Provider Demographics
NPI:1669980850
Name:ESCALERA, DENISE MARIE (REGISTERED NURSE- RN)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:MARIE
Last Name:ESCALERA
Suffix:
Gender:F
Credentials:REGISTERED NURSE- RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:343 MAIN ST NW
Mailing Address - Street 2:
Mailing Address - City:LOS LUNAS
Mailing Address - State:NM
Mailing Address - Zip Code:87031-8712
Mailing Address - Country:US
Mailing Address - Phone:505-865-2045
Mailing Address - Fax:
Practice Address - Street 1:343 MAIN ST NW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-8712
Practice Address - Country:US
Practice Address - Phone:505-865-2045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-01-22
Last Update Date:2018-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-79324163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool