MEDICARE: RITA ANNE SENATOR RN, MSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WC0400X	Case Management Registered Nurse	RN-80418	NM

General Provider Information

NPI Number	:	1013367291
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RITA ANNE SENATOR RN, MSN

Provider Business Mailing Address
First Line	:	1265 BIG ROCK LOOP
Second Line	:
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2852
Country	:	US
Telephone Number	:	505-500-6575
Fax Number	:

Provider Business Practice Location Address
First Line	:	1265 BIG ROCK LOOP
Second Line	:
City	:	LOS ALAMOS
State	:	NM
Zip	:	87544-2852
Country	:	US
Telephone Number	:	505-500-6575
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/17/2016
Last Update Date	:	06/17/2016

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