Healthcare Provider Details

I. General information

NPI: 1689230658
Provider Name (Legal Business Name): NORMA ARACELI ORTEGA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2019
Last Update Date: 05/15/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9319 STARBOARD RD NW
ALBUQUERQUE NM
87121-1968
US

IV. Provider business mailing address

PO BOX 53184
ALBUQUERQUE NM
87153-3184
US

V. Phone/Fax

Practice location:
  • Phone: 505-333-8755
  • Fax:
Mailing address:
  • Phone: 505-333-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251E00000X
TaxonomyHome Health Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: