Provider Demographics
NPI:1780139394
Name:FRESQUEZ, ASPEN
Entity type:Individual
Prefix:MRS
First Name:ASPEN
Middle Name:
Last Name:FRESQUEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4501 SPRINT BLVD NE APT 8304
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-9130
Mailing Address - Country:US
Mailing Address - Phone:505-415-4384
Mailing Address - Fax:
Practice Address - Street 1:6565 AMERICAS PKWY NE STE 200
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-8172
Practice Address - Country:US
Practice Address - Phone:505-273-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes373H00000XNursing Service Related ProvidersDay Training/Habilitation Specialist