MEDICARE: CHOICE HEALTH NM LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner

General Provider Information

NPI Number	:	1346121910
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHOICE HEALTH NM LLC

Provider Business Mailing Address
First Line	:	10309 AVENIDA VISTA CERROS NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-5907
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10309 AVENIDA VISTA CERROS NW
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87114-5907
Country	:	US
Telephone Number	:	806-438-2006
Fax Number	:

Authorized Official
Title or Position	:	AUTHORIZED OFFICIAL
Name	:	TODD ROYAL
Credential	:
Telephone Number	:	806-438-2006

Provider Enumeration Date	:	09/10/2025
Last Update Date	:	03/04/2026

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Directions to “CHOICE HEALTH NM LLC ” Practice Location

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