Healthcare Provider Details

I. General information

NPI: 1417620832
Provider Name (Legal Business Name): CHERYL DAWN ARMSTRONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2021
Last Update Date: 07/30/2021
Certification Date: 07/15/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12016 CARL CT NE
ALBUQUERQUE NM
87112-4501
US

IV. Provider business mailing address

12016 CARL CT NE
ALBUQUERQUE NM
87112-4501
US

V. Phone/Fax

Practice location:
  • Phone: 505-259-2484
  • Fax:
Mailing address:
  • Phone: 505-259-2484
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172P00000X
TaxonomyNaprapath
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: