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General NPI Number Information
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NPI Number | 1801464243
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Entity Type | Organization
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Legal Business Name | BAIRNS PSYCHIATRIC GROUP LLC
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Dates
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Enumeration Date | 06/13/2021
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Last Update Date | 10/08/2024
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Provider Practice Location Address
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Address Line | 718 10TH ST STE W
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City | ALAMOGORDO
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State | NM
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Zip | 88310-6777
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Country | US
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Telephone | 575-489-6171
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Fax | 877-838-0737
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Provider Business Mailing Address
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Address Line | 718 10TH ST STE W
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City | ALAMOGORDO
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State | NM
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Zip | 88310-6777
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Country | US
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Telephone | 575-489-6171
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Fax | 877-838-0737
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Authorized Official
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Title or Position | PROVIDER
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Name | CECILIA ISOLINA KASBOHM
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Credential | CNP
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Telephone | 575-489-6171
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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