Provider Demographics
NPI:1386251957
Name:DORADO, CIERRA
Entity type:Individual
Prefix:
First Name:CIERRA
Middle Name:
Last Name:DORADO
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 1:1862 PECOS HWY
Mailing Address - Street 2:
Mailing Address - City:LOVING
Mailing Address - State:NM
Mailing Address - Zip Code:88256-9725
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:104 QUAIL TRL
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:NM
Practice Address - Zip Code:87015-7185
Practice Address - Country:US
Practice Address - Phone:505-208-0204
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-28
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM61187363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily