Ms Bernadette Dayzie, CNP | |
Kewa Pueblo Health Corporation, 85 W Hwy 22, Santo Domingo Pueblo, NM 87052 | |
(505) 465-3060 | |
Not Available |
Full Name | Ms Bernadette Dayzie |
---|---|
Gender | Female |
Speciality | Nurse Practitioner - Pediatrics |
Location | Kewa Pueblo Health Corporation, 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 |
---|---|---|---|
1245393032 | NPI | - | NPPES |
000Z7054 | Medicaid | NM |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LP0200X | Nurse Practitioner - Pediatrics | 105014 (Colorado) | Primary |
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 |
---|---|
Ms Bernadette Dayzie, CNP Po Box 340, Santo Domingo Pueblo, NM 87052-0340 Ph: (505) 465-3060 | Ms Bernadette Dayzie, CNP Kewa Pueblo Health Corporation, 85 W Hwy 22, Santo Domingo Pueblo, NM 87052 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 | |
Johannah Renee Yazzie, CPNP-PC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 85 W Highway 22, Santo Domingo Pueblo, NM 87052 Phone: 505-465-3060 Fax: 505-591-0304 | |
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 |