Healthcare Provider Details

I. General information

NPI: 1316495617
Provider Name (Legal Business Name): CONTESSA JARAMILLO PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2016
Last Update Date: 09/14/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 E LOHMAN AVE
LAS CRUCES NM
88001-8492
US

IV. Provider business mailing address

2775 N ROADRUNNER PKWY APT 2304
LAS CRUCES NM
88011-8132
US

V. Phone/Fax

Practice location:
  • Phone: 575-647-2506
  • Fax:
Mailing address:
  • Phone: 575-652-7850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00008597
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: