Healthcare Provider Details

I. General information

NPI: 1235285180
Provider Name (Legal Business Name): ADRIENNE VARBEL LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/25/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4100 SARA RD SE RR7 MAILSTOP 108
RIO RANCHO NM
87124-1025
US

IV. Provider business mailing address

5113 REDLANDS RD NW
ALBUQUERQUE NM
87120-1244
US

V. Phone/Fax

Practice location:
  • Phone: 505-450-1808
  • Fax:
Mailing address:
  • Phone: 505-450-1808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number4646
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: