Provider Demographics
NPI:1174007561
Name:CANO VAZQUEZ, NADIA L (CNP)
Entity type:Individual
Prefix:
First Name:NADIA
Middle Name:L
Last Name:CANO VAZQUEZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E SPRUCE ST STE 1
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88030-3865
Mailing Address - Country:US
Mailing Address - Phone:575-936-4207
Mailing Address - Fax:575-936-4077
Practice Address - Street 1:800 E SPRUCE ST STE 1
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030-3865
Practice Address - Country:US
Practice Address - Phone:575-936-4207
Practice Address - Fax:575-936-4077
Is Sole Proprietor?:No
Enumeration Date:2018-09-20
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ250792363L00000X
NM53843363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner