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General NPI Number Information
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NPI Number | 1609165067
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Entity Type | Organization
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Legal Business Name | HEALTHNET MEDICAL FAMILY & INTERNAL MEDICINE LLC
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Dates
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Enumeration Date | 04/06/2011
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Last Update Date | 03/19/2014
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Provider Practice Location Address
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Address Line | 300 MCCOMBS RD # 235
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City | CHAPARRAL
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State | NM
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Zip | 88081-7937
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Country | US
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Telephone | 915-920-7783
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Fax | 866-596-6125
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Provider Business Mailing Address
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Address Line | 300 MCCOMBS RD # 235
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City | CHAPARRAL
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State | NM
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Zip | 88081-7937
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Country | US
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Telephone | 915-920-7783
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Fax | 866-596-6125
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Authorized Official
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Title or Position | OWNER
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Name | MS. MARIA ADELINA FRISBIE-VEAL
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Credential | FNP-C
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Telephone | 915-920-7783
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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 | CNP01432
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 658423
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License Number State | TX
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