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NPI Code Detail

MEDICARE: STEPHANIE RABARA OMER

MEDICARE: STEPHANIE RABARA OMER
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
1390200000XStudent in an Organized Health Care Education/Training ProgramNM

General Provider Information

NPI Number : 1750001715
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE RABARA OMER
Provider Business Mailing Address
First Line : 1 UNIVERSITY OF NEW MEXICO
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87131-0001
Country : US
Telephone Number : 505-272-4161
Fax Number :
Provider Business Practice Location Address
First Line : 2211 LOMAS BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87106-2719
Country : US
Telephone Number : 505-272-2111
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/30/2022
Last Update Date : 04/15/2026

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Directions to “ STEPHANIE RABARA OMER ” Practice Location

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