Chantala Booth
Individual provider Active NPI School Registered Nurse · Moriarty, NM
NPI 1043045636 · NPPES record last updated Sep 4, 2024
Key facts
- NPI
- 1043045636
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Registered Nurse 163WS0200X
- License
- RN-82148 (NM)
- Practice address
- 2422 State Highway 333
Moriarty, NM 87035 - Phone
- (505) 274-3354
- NPI assigned
- Sep 4, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|
| RN-82148 | NM | MD | School Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | RN-82148 | NM | Yes |
Addresses
Primary practice location
2422 State Highway 333
Moriarty, NM 87035
Mailing address
PO Box 604
Moriarty, NM 87035-0604
Phone (505) 274-3354
Other providers in Moriarty, NM
- Melody Michelle Benavidez
- Gabrielle Elizabeth Benitez
- Keirstin Bennett
- Kimberly A Birch
- Nicholas J. Black
- Kathleen Brown
- Shannon Marie Burke
- City of Moriarty
- Jennifer Como
- Cornerstone Integrated Health LLC
All providers in Moriarty, NM · School 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 Sep 4, 2024. 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.