Provider Demographics
NPI:1386702983
Name:CATHERINE VEILLEUX CFNP LLC
Entity type:Organization
Organization Name:CATHERINE VEILLEUX CFNP LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:VEILLEUX
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:505-747-3368
Mailing Address - Street 1:2886 PLAZA BLANCA
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87507-6515
Mailing Address - Country:US
Mailing Address - Phone:505-747-3368
Mailing Address - Fax:505-747-3368
Practice Address - Street 1:509 W PUEBLO DR
Practice Address - Street 2:
Practice Address - City:ESPANOLA
Practice Address - State:NM
Practice Address - Zip Code:87532-2508
Practice Address - Country:US
Practice Address - Phone:505-747-3368
Practice Address - Fax:505-747-3368
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR25534261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM1942248844OtherNPI ENUMERATOR
NM00068425Medicaid