Healthcare Provider Details

I. General information

NPI: 1568621324
Provider Name (Legal Business Name): ANNE T STATS RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/06/2008
Last Update Date: 11/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2600 MARBLE, RRP CLINIC MENTAL HEALTH CENTER, UNMH
ALBUQUERQUE NM
87131-5426
US

IV. Provider business mailing address

2600 MARBLE, RRP CLINIC MENTAL HEALTH CENTER, UNMH
ALBUQUERQUE NM
87131-5426
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-2800
  • Fax: 505-272-9843
Mailing address:
  • Phone: 505-272-2800
  • Fax: 505-272-9843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN-76277
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: