Healthcare Provider Details

I. General information

NPI: 1730099243
Provider Name (Legal Business Name): RAE NEVA ROUMPF
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/08/2026
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

IV. Provider business mailing address

2211 LOMAS BLVD NE
ALBUQUERQUE NM
87106-2719
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-5928
  • Fax: 505-272-6620
Mailing address:
  • Phone: 505-272-5928
  • Fax: 505-272-6620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number48080
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: