Healthcare Provider Details

I. General information

NPI: 1093937450
Provider Name (Legal Business Name): PAMELA RAE FIELD R.N. C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5305 MOUNTAIN RD NE
ALBUQUERQUE NM
87110-6417
US

IV. Provider business mailing address

5305 MOUNTAIN RD NE
ALBUQUERQUE NM
87110-6417
US

V. Phone/Fax

Practice location:
  • Phone: 505-265-5008
  • Fax:
Mailing address:
  • Phone: 505-265-5008
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0808X
TaxonomyPsychiatric/Mental Health Registered Nurse
License NumberR30082
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: