Provider Demographics
NPI:1144553223
Name:SANCHEZ, JUDY BRENDA (RN)
Entity type:Individual
Prefix:MS
First Name:JUDY
Middle Name:BRENDA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 SULTAN ST
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NM
Mailing Address - Zip Code:87701-8990
Mailing Address - Country:US
Mailing Address - Phone:505-425-9201
Mailing Address - Fax:
Practice Address - Street 1:5312 SULTAN ST
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NM
Practice Address - Zip Code:87701-8990
Practice Address - Country:US
Practice Address - Phone:505-425-9201
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-08
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM74555332Medicaid