Provider Demographics
NPI:1902621360
Name:BAGAYAS, CYRENE MAY IBANEZ (REGISTERED NURSE)
Entity type:Individual
Prefix:
First Name:CYRENE MAY
Middle Name:IBANEZ
Last Name:BAGAYAS
Suffix:
Gender:F
Credentials:REGISTERED NURSE
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1102 S TABOR AVE APT 602
Mailing Address - Street 2:
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-7765
Mailing Address - Country:US
Mailing Address - Phone:308-660-1470
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 358
Practice Address - Street 2:
Practice Address - City:CROWNPOINT
Practice Address - State:NM
Practice Address - Zip Code:87313-0358
Practice Address - Country:US
Practice Address - Phone:505-786-5291
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-20
Last Update Date:2024-11-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NE92761163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical