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General NPI Number Information
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NPI Number | 1477759322
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Entity Type | Organization
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Legal Business Name | ON CALL HEALTH SERVICES OF NEW MEXICO LLC
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Dates
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Enumeration Date | 06/26/2007
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Last Update Date | 12/06/2007
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Provider Practice Location Address
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Address Line | 931 CAMINO RANCHITOS NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-1815
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Country | US
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Telephone | 505-450-7457
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Fax |
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Provider Business Mailing Address
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Address Line | 931 CAMINO RANCHITOS NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87114-1815
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Country | US
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Telephone | 505-450-7457
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | FRANCES KATHLEEN (KATHY) LOPEZ-BUSHNELL
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Credential | CNP
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Telephone | 505-450-7457
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | RN09379
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License Number State | NM
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