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NPI Code Detail

MEDICARE: SAMANTHA TOLEMAN RN

MEDICARE: SAMANTHA TOLEMAN RN
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
1103K00000XBehavior Analyst
2163WS0200XSchool Registered NurseRN-82678NM

General Provider Information

NPI Number : 1467764431
Entity Type Code : Individual
Provider Name (Legal Business Name) : SAMANTHA TOLEMAN RN
Provider Business Mailing Address
First Line : PO BOX 25704
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87125-0704
Country : US
Telephone Number : 505-804-9023
Fax Number : 505-342-5450
Provider Business Practice Location Address
First Line : 6400 UPTOWN BLVD NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-4202
Country : US
Telephone Number : 505-855-9893
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2010
Last Update Date : 09/18/2024

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