Healthcare Provider Details

I. General information

NPI: 1316893977
Provider Name (Legal Business Name): RAMONA Q QUIROZ DE URBINA I CHW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 MERIDA DR
ANTHONY NM
88021-8225
US

IV. Provider business mailing address

248 MERIDA DR
ANTHONY NM
88021-8225
US

V. Phone/Fax

Practice location:
  • Phone: 915-979-5930
  • Fax: 915-979-5930
Mailing address:
  • Phone: 915-979-5930
  • Fax: 915-979-5930

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License NumberS1-182
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: