Healthcare Provider Details

I. General information

NPI: 1215587274
Provider Name (Legal Business Name): DANIEL C ATKINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/12/2019
Last Update Date: 09/17/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8209 LA CAVERNA AVE NE
ALBUQUERQUE NM
87122-1373
US

IV. Provider business mailing address

8209 LA CAVERNA AVE NE
ALBUQUERQUE NM
87122-1373
US

V. Phone/Fax

Practice location:
  • Phone: 505-366-3087
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3747A0650X
TaxonomyAttendant Care Provider
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: