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General NPI Number Information
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NPI Number | 1275035321
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Entity Type | Individual
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Provider Name | VANESSA MARIA NAIMOLI
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Gender | Female
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Dates
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Enumeration Date | 03/05/2018
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Last Update Date | 04/10/2024
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Provider Practice Location Address
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Address Line | 2050A 2ND ST SE
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City | KIRTLAND AFB
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State | NM
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Zip | 87117-3875
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Country | US
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Telephone | 505-846-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 2050A 2ND ST SE
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City | KIRTLAND AFB
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State | NM
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Zip | 87117-5901
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Country | US
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Telephone | 505-846-3200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 65967
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN-89322
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License Number State | NM
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