Provider Demographics
NPI:1356985170
Name:ENRIQUEZ, CLAUDIA ELIZABETH
Entity type:Individual
Prefix:
First Name:CLAUDIA
Middle Name:ELIZABETH
Last Name:ENRIQUEZ
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 1:74 FORSYTH RD
Mailing Address - Street 2:
Mailing Address - City:ALAMOGORDO
Mailing Address - State:NM
Mailing Address - Zip Code:88310-9656
Mailing Address - Country:US
Mailing Address - Phone:575-405-9453
Mailing Address - Fax:
Practice Address - Street 1:1200 N WHITE SANDS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:ALAMOGORDO
Practice Address - State:NM
Practice Address - Zip Code:88310-6774
Practice Address - Country:US
Practice Address - Phone:575-488-0038
Practice Address - Fax:575-488-0032
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-05
Last Update Date:2025-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM58290207Q00000X, 363LF0000X
NM261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty