Healthcare Provider Details
I. General information
NPI: 1700106317
Provider Name (Legal Business Name): MRS. CHRISTY F MACMURCHADHA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 06/04/2010
Last Update Date: 06/04/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
184 UNSER BLVD NE
RIO RANCHO NM
87124-4045
US
IV. Provider business mailing address
184 UNSER BLVD NE
RIO RANCHO NM
87124-4045
US
V. Phone/Fax
- Phone: 505-896-0928
- Fax: 505-892-8829
- Phone: 505-896-0928
- Fax: 505-892-8829
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171M00000X |
| Taxonomy | Case Manager/Care Coordinator |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: