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General NPI Number Information
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NPI Number | 1669285409
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Entity Type | Organization
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Legal Business Name | INDIGO SUN PALLIATIVE CARE
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Dates
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Enumeration Date | 01/27/2025
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Last Update Date | 01/27/2025
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Provider Practice Location Address
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Address Line | 4273 MONTGOMERY BLVD NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-6746
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Country | US
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Telephone | 505-365-0321
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Fax | 505-520-0131
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Provider Business Mailing Address
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Address Line | 4273 MONTGOMERY BLVD NE STE 110
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-6746
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Country | US
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Telephone | 505-365-0321
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Fax | 505-520-0131
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Authorized Official
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Title or Position | BOARD MEMBER
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Name | LAURA HOLLINGSWORTH
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Credential | RN
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Telephone | 505-365-0321
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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