| Organization Name: | NORTHWEST REIONAL EDUCATION COOP #2 |
| NPI Number: | 1720331697 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | KIMBERLY MIZELL (DIRECTOR) |
| Mailing Address: | 91 Hawk Drive Dulce |
| State: | NM US |
| Postal Code: | 87528 |
| Phone Number: | 5757592909 |
| Fax Number: | 5757593533 |
| NPI Enumeration Date: | 10/17/2012 |
| NPI Last Update Date: | 02/08/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | 02314459009 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NM |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |