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NPI Code Detail

MEDICARE: JAMIE LYNN VIGIL

MEDICARE: JAMIE LYNN VIGIL
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1679288757
Entity Type Code : Individual
Provider Name (Legal Business Name) : JAMIE LYNN VIGIL
Provider Business Mailing Address
First Line : 2325 CERRILLOS RD
Second Line :
City : SANTA FE
State : NM
Zip : 87505-3377
Country : US
Telephone Number : 505-438-0010
Fax Number : 505-438-6011
Provider Business Practice Location Address
First Line : 2325 CERRILLOS RD
Second Line :
City : SANTA FE
State : NM
Zip : 87505-3377
Country : US
Telephone Number : 505-438-0010
Fax Number : 505-438-6011
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2023
Last Update Date : 01/23/2023

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Directions to “ JAMIE LYNN VIGIL ” Practice Location

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