Johannah Renee Yazzie, CPNP-PC | |
85 W Highway 22, Santo Domingo Pueblo, NM 87052-1283 | |
(505) 465-3060 | |
(505) 591-0304 |
Full Name | Johannah Renee Yazzie |
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Gender | Female |
Speciality | Nurse Practitioner - Pediatrics |
Location | 85 W Highway 22, Santo Domingo Pueblo, New Mexico |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1164941621 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0200X | Nurse Practitioner - Pediatrics | CNP-03377 (New Mexico) | Primary |
Entity Name | Dhew Ind Hlth Sv Hlth Svs & Mntl Hlth Adm |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1083643738 PECOS PAC ID: 1759290901 Enrollment ID: O20031105000797 |
Entity Name | Kewa Pueblo Health Corporation |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1467739888 PECOS PAC ID: 7618137779 Enrollment ID: O20120327000617 |
Mailing Address | Practice Location Address |
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Johannah Renee Yazzie, CPNP-PC Po Box 340, Santo Domingo Pueblo, NM 87052-0340 Ph: (505) 465-3060 | Johannah Renee Yazzie, CPNP-PC 85 W Highway 22, Santo Domingo Pueblo, NM 87052-1283 Ph: (505) 465-3060 |
Carmen Salazar, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 85 W Highway 22, Santo Domingo Pueblo, NM 87052 Phone: 505-465-3060 | |
Mrs. Tina T Bui-burgos, CNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 85 West Highway 22, Kewa Pueblo Health Corporation, Santo Domingo Pueblo, NM 87052 Phone: 505-465-3060 Fax: 505-465-1191 | |
Ms. Bernadette Dayzie, CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: Kewa Pueblo Health Corporation, 85 W Hwy 22, Santo Domingo Pueblo, NM 87052 Phone: 505-465-3060 |