MEDICARE: MS. SARA J GARCIA 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
1	163W00000X	Registered Nurse	RN69680	NM

General Provider Information

NPI Number	:	1548569874
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SARA J GARCIA RN

Provider Business Mailing Address
First Line	:	4055 MONTGOMERY BLVD NE
Second Line	:	SUITE B
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-1178
Country	:	US
Telephone Number	:	505-884-4464
Fax Number	:	505-884-0093

Provider Business Practice Location Address
First Line	:	4055 MONTGOMERY BLVD NE
Second Line	:	SUITE B
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87109-1178
Country	:	US
Telephone Number	:	505-884-4464
Fax Number	:	505-884-0093

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

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	03/25/2011

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