MEDICARE: CHRISTIAN READMOND

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	171M00000X	Case Manager/Care Coordinator

General Provider Information

NPI Number	:	1447631742
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTIAN READMOND

Provider Business Mailing Address
First Line	:	282 S CAMINO DEL PUEBLO
Second Line	:	2C
City	:	BERNALILLO
State	:	NM
Zip	:	87004-5909
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	428 LOS LENTES RD SE
Second Line	:	STE 3
City	:	LOS LUNAS
State	:	NM
Zip	:	87031-6018
Country	:	US
Telephone Number	:	505-865-3350
Fax Number	:

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

Provider Enumeration Date	:	06/11/2015
Last Update Date	:	06/11/2015

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Directions to “ CHRISTIAN READMOND ” Practice Location

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