Provider Demographics
NPI:1871359125
Name:VAVRA, CURTISS JOHN (RN, PHD)
Entity type:Individual
Prefix:DR
First Name:CURTISS
Middle Name:JOHN
Last Name:VAVRA
Suffix:
Gender:M
Credentials:RN, PHD
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 1:9628 VISTA CASITAS DR NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-3720
Practice Address - Country:US
Practice Address - Phone:505-301-1660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-26
Last Update Date:2024-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR27383163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse