Healthcare Provider Details

I. General information

NPI: 1841115938
Provider Name (Legal Business Name): KAYLEE-RHAE MARIE ROMERO CCSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

53 SANDIA HAVEN DR
CEDAR CREST NM
87008-9425
US

IV. Provider business mailing address

PO BOX 224
CEDAR CREST NM
87008-0224
US

V. Phone/Fax

Practice location:
  • Phone: 575-636-5022
  • Fax:
Mailing address:
  • Phone: 575-636-5022
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: