Healthcare Provider Details

I. General information

NPI: 1114080595
Provider Name (Legal Business Name): MARGERY JULINE BAROL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/18/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1217 1ST ST NW
ALBUQUERQUE NM
87102-1529
US

IV. Provider business mailing address

1217 1ST ST NW PO BOX 25445
ALBUQUERQUE NM
87102-1529
US

V. Phone/Fax

Practice location:
  • Phone: 505-242-4644
  • Fax: 505-242-3531
Mailing address:
  • Phone: 505-242-4644
  • Fax: 505-242-3531

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN14652
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: