Provider Demographics
NPI:1194687681
Name:NEXUS VITALITY CENTER
Entity type:Organization
Organization Name:NEXUS VITALITY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SAMMY
Authorized Official - Middle Name:
Authorized Official - Last Name:NZIVO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:702-945-8262
Mailing Address - Street 1:6001 MENAUL BLVD NE # 1107
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-3379
Mailing Address - Country:US
Mailing Address - Phone:702-945-8262
Mailing Address - Fax:
Practice Address - Street 1:6001 MENAUL BLVD NE # 1107
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87110-3379
Practice Address - Country:US
Practice Address - Phone:702-945-8262
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-12-02
Last Update Date:2025-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Multi-Specialty