Individual provider · NPI-1
Laurie L Vigne, RN, CDE
Registered Nurse, Diabetes Educator · Espanola, NM
NPI number1780799452
StatusActive
Last updated in NPPESJan 8, 2021
Details
- NPI
- 1780799452
- Entity type
- Individual (NPI-1)
- Name
- Laurie L Vigne
- Credential
- RN, CDE
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 20, 2006
- Certification date
- Jan 8, 2021
- Last updated
- Jan 8, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 163WD0400X | Registered Nurse, Diabetes Educator | R27926 | NM | Yes |
| 132700000X | Dietary Manager | R27926 | NM |
Other names
- Laurie L Yelvington (Former Name)
Practice location
1010 Spruce StEspanola Multi-Specialty Clinic
Espanola, NM 87532-2724
Phone 505-753-8031 · Fax 505-753-7433
Mailing address
Po Box 26666Phs Provider Enrollment
Albuquerque, NM 87125-6666
Phone 505-923-6770
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