Healthcare Provider Details

I. General information

NPI: 1821146358
Provider Name (Legal Business Name): KAREN E ROMERO LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/20/2007
Certification Date:
Deactivation Date: 07/17/2007
Reactivation Date: 08/20/2007

III. Provider practice location address

343 MAIN ST NW
LOS LUNAS NM
87031
US

IV. Provider business mailing address

PO BOX 192
TOME NM
87060
US

V. Phone/Fax

Practice location:
  • Phone: 505-866-8340
  • Fax: 505-866-2180
Mailing address:
  • Phone: 505-269-2816
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberM05716
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code1041S0200X
TaxonomySchool Social Worker
License NumberM05716
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: