MEDICARE: DR. LORRAINE R. HERRERA DOM

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	171100000X	Acupuncturist	823	NM

General Provider Information

NPI Number	:	1265584361
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LORRAINE R. HERRERA DOM

Provider Business Mailing Address
First Line	:	4401 SILVER AVE SE
Second Line	:	SUITE H
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-2856
Country	:	US
Telephone Number	:	505-268-2688
Fax Number	:

Provider Business Practice Location Address
First Line	:	4401 SILVER AVE SE
Second Line	:	SUITE H
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87108-2856
Country	:	US
Telephone Number	:	505-268-2688
Fax Number	:

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

Provider Enumeration Date	:	01/17/2007
Last Update Date	:	07/08/2007

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