Healthcare Provider Details

I. General information

NPI: 1508745530
Provider Name (Legal Business Name): MARIYAM SAHO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7717 OAKLAND AVE NE
ALBUQUERQUE NM
87122-2764
US

IV. Provider business mailing address

7717 OAKLAND AVE NE
ALBUQUERQUE NM
87122-2764
US

V. Phone/Fax

Practice location:
  • Phone: 505-850-2935
  • Fax:
Mailing address:
  • Phone: 505-850-2935
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License NumberRN-87824
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: