Healthcare Provider Details

I. General information

NPI: 1457107690
Provider Name (Legal Business Name): TONI ROCHELLE REED RN BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TONI ROCHELLE KING

II. Dates (important events)

Enumeration Date: 04/29/2024
Last Update Date: 04/29/2024
Certification Date: 04/28/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2502 MARBLE AVE
ALBUQUERQUE NM
87131-0001
US

IV. Provider business mailing address

4201 AZALEA ST
FARMINGTON NM
87402-1751
US

V. Phone/Fax

Practice location:
  • Phone: 800-690-0934
  • Fax:
Mailing address:
  • Phone: 505-947-7335
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: