Organization Name: | HEALTHNET MEDICAL FAMILY & INTERNAL MEDICINE LLC |
NPI Number: | 1609165067 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MARIA ADELINA FRISBIE-VEAL (OWNER) |
Mailing Address: | 300 Mccombs Rd # 235 Chaparral |
State: | NM US |
Postal Code: | 880817937 |
Phone Number: | 9159207783 |
Fax Number: | 8665966125 |
NPI Enumeration Date: | 04/06/2011 |
NPI Last Update Date: | 03/19/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | CNP01432 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NM |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |