Provider Demographics
NPI:1427871367
Name:TERRAZAS, NALLELY
Entity type:Individual
Prefix:
First Name:NALLELY
Middle Name:
Last Name:TERRAZAS
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 1:1531 GEORGE DIETER DR APT 1017
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79936-7673
Mailing Address - Country:US
Mailing Address - Phone:915-252-4351
Mailing Address - Fax:
Practice Address - Street 1:1255 COUNTRY CLUB RD STE D
Practice Address - Street 2:
Practice Address - City:SANTA TERESA
Practice Address - State:NM
Practice Address - Zip Code:88008-9707
Practice Address - Country:US
Practice Address - Phone:575-522-9595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-07
Last Update Date:2024-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator