Healthcare Provider Details

I. General information

NPI: 1942484563
Provider Name (Legal Business Name): HARRIET JAMES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2007
Last Update Date: 04/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 JAGER DR NE SUITE C
RIO RANCHO NM
87144-7523
US

IV. Provider business mailing address

4351 JAGER DR NE SUITE C
RIO RANCHO NM
87144-7523
US

V. Phone/Fax

Practice location:
  • Phone: 505-771-1180
  • Fax: 505-771-2688
Mailing address:
  • Phone: 505-771-1180
  • Fax: 505-771-2688

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR37554
License Number StateNM

VIII. Authorized Official

Name: HARRIET L. JAMES
Title or Position: OWNER
Credential: NP
Phone: 505-771-1180