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General NPI Number Information
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NPI Number | 1457794349
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Entity Type | Individual
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Provider Name | RICHARD EARNEST
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Gender | Male
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Dates
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Enumeration Date | 04/10/2013
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Last Update Date | 02/24/2015
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Provider Practice Location Address
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Address Line | 2432 CERRILLOS RD
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City | SANTA FE
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State | NM
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Zip | 87505-3392
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Country | US
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Telephone | 505-424-1066
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Fax |
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Provider Business Mailing Address
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Address Line | 2432 CERRILLOS RD
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City | SANTA FE
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State | NM
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Zip | 87505
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Country | US
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Telephone |
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 80581
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 0852
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License Number State | NM
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