Provider Demographics
NPI:1487048609
Name:SANCHEZ, LORRAINE GLORIA (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:LORRAINE
Middle Name:GLORIA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:LORI
Other - Middle Name:GLORIA
Other - Last Name:YU
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:755 S TELSHOR BLVD STE S102
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-4688
Mailing Address - Country:US
Mailing Address - Phone:575-222-4355
Mailing Address - Fax:575-800-0344
Practice Address - Street 1:755 S TELSHOR BLVD STE S102
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-4688
Practice Address - Country:US
Practice Address - Phone:575-222-4355
Practice Address - Fax:575-800-0344
Is Sole Proprietor?:No
Enumeration Date:2015-03-25
Last Update Date:2021-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02609363LF0000X
NMCNP02609363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM28909585Medicaid
NM413154YRNDOtherMEDICARE