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NPI Code Detail

MEDICARE: CATHERINE AVERY

MEDICARE: CATHERINE AVERY
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
1363LF0000XFamily Nurse PractitionerR34552NM

General Provider Information

NPI Number : 1750411039
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE AVERY
Provider Business Mailing Address
First Line : 1190 S SAINT FRANCIS DR RM N-1350
Second Line :
City : SANTA FE
State : NM
Zip : 87505-4173
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1190 S SAINT FRANCIS DR RM N-1350
Second Line :
City : SANTA FE
State : NM
Zip : 87505-4173
Country : US
Telephone Number : 505-827-0083
Fax Number : 505-827-0013
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2007
Last Update Date : 07/08/2007

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Directions to “ CATHERINE AVERY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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