Provider Demographics
NPI:1902456452
Name:MENDOZA-MARCIAL, KARINA YVETTE (NP)
Entity Type:Individual
Prefix:
First Name:KARINA
Middle Name:YVETTE
Last Name:MENDOZA-MARCIAL
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
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Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:7518 SANDY SPRINGS PT
Mailing Address - Street 2:
Mailing Address - City:FOUNTAIN
Mailing Address - State:CO
Mailing Address - Zip Code:80817-4076
Mailing Address - Country:US
Mailing Address - Phone:915-915-8921
Mailing Address - Fax:000-000-0000
Practice Address - Street 1:10921 PELLICANO DR STE 121
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79935-4604
Practice Address - Country:US
Practice Address - Phone:915-320-7707
Practice Address - Fax:915-892-1531
Is Sole Proprietor?:No
Enumeration Date:2019-09-17
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP143048363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily