Provider Demographics
NPI:1538223771
Name:SAIZ, MARY P (WHCNP)
Entity type:Individual
Prefix:MISS
First Name:MARY
Middle Name:P
Last Name:SAIZ
Suffix:
Gender:F
Credentials:WHCNP
Other - Prefix:MISS
Other - First Name:MARY
Other - Middle Name:PRUDENCE
Other - Last Name:SAIZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:WHCNP-BC
Mailing Address - Street 1:1600 NORTH MAIN
Mailing Address - Street 2:
Mailing Address - City:LOVINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:88260-2830
Mailing Address - Country:US
Mailing Address - Phone:575-396-6611
Mailing Address - Fax:575-396-1454
Practice Address - Street 1:1600 NORTH MAIN
Practice Address - Street 2:
Practice Address - City:LOVINGTON
Practice Address - State:NM
Practice Address - Zip Code:88260-2830
Practice Address - Country:US
Practice Address - Phone:575-396-6611
Practice Address - Fax:575-396-1454
Is Sole Proprietor?:No
Enumeration Date:2006-12-21
Last Update Date:2017-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX573502363LW0102X
NMCNP00669363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM509510YNGGOtherPTAN
NMNM006J89OtherBCBS
NM25658522Medicaid
NMNM006J89OtherBCBS
NMNM300112Medicare PIN