Healthcare Provider Details

I. General information

NPI: 1194955252
Provider Name (Legal Business Name): CAROLYN EILEEN ROMERO R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2009
Last Update Date: 07/22/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 COPPERHEAD CT NE
ALBUQUERQUE NM
87113-2299
US

IV. Provider business mailing address

900 COPPERHEAD CT NE
ALBUQUERQUE NM
87113-2299
US

V. Phone/Fax

Practice location:
  • Phone: 505-839-8283
  • Fax: 505-291-2133
Mailing address:
  • Phone: 505-839-8283
  • Fax: 505-291-2133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR51865
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: