Healthcare Provider Details

I. General information

NPI: 1609355536
Provider Name (Legal Business Name): ROBERT FROHMADER AG-ACNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2018
Last Update Date: 08/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 CEDAR ST SE STE 7600
ALBUQUERQUE NM
87106-4921
US

IV. Provider business mailing address

10104 WICKENBURG ST NW
ALBUQUERQUE NM
87114-3967
US

V. Phone/Fax

Practice location:
  • Phone: 505-563-2500
  • Fax: 505-563-2599
Mailing address:
  • Phone: 505-205-8644
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number53364
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: