Healthcare Provider Details

I. General information

NPI: 1932504644
Provider Name (Legal Business Name): CARMEN H VALVERDE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/24/2014
Last Update Date: 10/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1170 N SOLANO DR STE C
LAS CRUCES NM
88001-2371
US

IV. Provider business mailing address

1170 N SOLANO DR STE C
LAS CRUCES NM
88001-2371
US

V. Phone/Fax

Practice location:
  • Phone: 575-528-5073
  • Fax: 575-528-6032
Mailing address:
  • Phone: 575-528-5073
  • Fax: 575-528-6032

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberB-08041
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: