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General NPI Number Information
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NPI Number | 1518838275
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Entity Type | Individual
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Provider Name | LORIELLA HADEN RN
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Gender | Female
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Dates
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Enumeration Date | 09/16/2025
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Last Update Date | 09/16/2025
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Provider Practice Location Address
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Address Line | PO BOX 5
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City | SAN JON
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State | NM
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Zip | 88434-0005
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Country | US
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Telephone | 575-576-2466
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Fax | 575-576-2523
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Provider Business Mailing Address
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Address Line | PO BOX 847
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City | PORTALES
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State | NM
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Zip | 88130-0847
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Country | US
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Telephone | 575-562-4458
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Fax | 575-562-4460
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R38100
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License Number State | NM
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