Provider Demographics
NPI:1144013939
Name:VALDEZ, TANYA (RN)
Entity type:Individual
Prefix:
First Name:TANYA
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:MARTINEZ
Other - Last Name:VALDEZ
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1640 OLD PECOS TRL STE E
Mailing Address - Street 2:
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505-4777
Mailing Address - Country:US
Mailing Address - Phone:505-386-1380
Mailing Address - Fax:
Practice Address - Street 1:1640 OLD PECOS TRL STE E
Practice Address - Street 2:
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505-4777
Practice Address - Country:US
Practice Address - Phone:505-386-1380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMRN-81120163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse