Provider Demographics
NPI:1871359125
Name:VAVRA, CURTISS JOHN (CNP, PHD, MSN)
Entity type:Individual
Prefix:DR
First Name:CURTISS
Middle Name:JOHN
Last Name:VAVRA
Suffix:
Gender:M
Credentials:CNP, PHD, MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9628 VISTA CASITAS DR NW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87114-3720
Mailing Address - Country:US
Mailing Address - Phone:505-301-1660
Mailing Address - Fax:
Practice Address - Street 1:5901 OURAY RD NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-1381
Practice Address - Country:US
Practice Address - Phone:505-836-0023
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2025-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR27383163W00000X
NM84621363LG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology