Healthcare Provider Details

I. General information

NPI: 1700914975
Provider Name (Legal Business Name): NINETTE LINDA RAMIREZ OTR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 CORRIZ DR SW 1400 CORRIZ S.W.
ALBUQUERQUE NM
87121-8311
US

IV. Provider business mailing address

1400 CORRIZ DR SW 1400 CORRIZ RD. S.W.
ALBUQUERQUE NM
87121-8311
US

V. Phone/Fax

Practice location:
  • Phone: 505-836-0623
  • Fax: 505-836-7734
Mailing address:
  • Phone: 505-836-0623
  • Fax: 505-836-7734

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number1134
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: