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General NPI Number Information
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NPI Number | 1669861506
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Entity Type | Organization
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Legal Business Name | SVELTE LLC
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 10/05/2015
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Provider Practice Location Address
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Address Line | 1300 LUISA ST STE 3B
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City | SANTA FE
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State | NM
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Zip | 87505-4177
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Country | US
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Telephone | 505-400-3889
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Fax |
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Provider Business Mailing Address
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Address Line | 1300 LUISA ST STE 3B
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City | SANTA FE
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State | NM
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Zip | 87505-4177
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Country | US
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Telephone | 505-400-3889
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. TRACY NYMEYER
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Credential |
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Telephone | 505-400-3889
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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 |
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License Number State |
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