Provider Demographics
NPI:1316671803
Name:SANCHEZ, MERYSA (FNP-C)
Entity type:Individual
Prefix:
First Name:MERYSA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:MERYSA
Other - Middle Name:
Other - Last Name:AVITIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2211 LOMAS BLVD NE
Mailing Address - Street 2:WLTC 4-ACC
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106
Mailing Address - Country:US
Mailing Address - Phone:505-272-2245
Mailing Address - Fax:505-272-1109
Practice Address - Street 1:2211 LOMAS BLVD NE
Practice Address - Street 2:WLTC 4-ACC
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106
Practice Address - Country:US
Practice Address - Phone:505-272-2245
Practice Address - Fax:505-272-1109
Is Sole Proprietor?:No
Enumeration Date:2022-07-12
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM68278363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily