Healthcare Provider Details

I. General information

NPI: 1346367356
Provider Name (Legal Business Name): FRANCES M MADRID R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

714 CALLE DON DIEGO
ESPANOLA NM
87532-3414
US

IV. Provider business mailing address

PO BOX 4203
FAIRVIEW NM
87533-4203
US

V. Phone/Fax

Practice location:
  • Phone: 505-367-3342
  • Fax:
Mailing address:
  • Phone: 505-852-4225
  • Fax: 505-852-4975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR47238
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: