Roseanne Chadborn

Individual provider Active NPI Case Manager/Care Coordinator · Deming, NM

NPI 1013168608 · NPPES record last updated Feb 11, 2015

Key facts

NPI
1013168608
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
901 W. Hickory St.
Deming, NM 88030
Phone
(575) 546-2174
Fax
(575) 544-4821
NPI assigned
Oct 1, 2008
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
5887NMMDMechanotherapist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes
Mechanotherapist 172M00000X 5887 NM

Addresses

Primary practice location

901 W. Hickory St.
Deming, NM 88030

Mailing address

100 W Griggs Ave
Las Cruces, NM 88001-1234
Phone (575) 647-2800

Other identifiers

IdentifierTypeStateIssuer
18677037MedicaidNM

Other providers in Deming, NM

All providers in Deming, NM · Case Manager/Care Coordinator in New Mexico

Sources for this page

Verify at the official NPI Registry.