Fred Owusu Bamfo, DNP
Individual provider Active NPI Case Management Registered Nurse · Gallup, NM
NPI 1013315324 · NPPES record last updated Dec 18, 2014
Key facts
- NPI
- 1013315324
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Management Registered Nurse 163WC0400X
- License
- 810711 (TX)
- Practice address
- 516 E Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (505) 722-1000
- NPI assigned
- Dec 18, 2014
- Sex
- Male
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| 810711 | TX | MD | Case Management Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Management Registered Nurse | 163WC0400X | 810711 | TX | Yes |
Addresses
Primary practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
PO Box 1337
Gallup, NM 87305-1337
Phone (505) 722-1000
Other providers in Gallup, NM
- Eric Balababa
- Christopher Cody Baldonado
- Walter Ernest Balfour
- Amanda Faye Ballard
- Joseph Ballow
- Mary Elizabeth Bange
- Claire Lyn Banks
- Princess Baoya
- Celes Barbone
- Shannon Elizabeth Bares
All providers in Gallup, NM · Case Management Registered Nurse in New Mexico
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 18, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.