Roberta Hartman, LMT,CMLDT
Individual provider Active NPI Specialist · Bosque Farms, NM
NPI 1104156793 · NPPES record last updated Oct 20, 2015
Key facts
- NPI
- 1104156793
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 3769 (NM)
- Practice address
- 635 Bosque Farms Blvd # 87068
1030 Stovall Ave Bosque Farms NM
Bosque Farms, NM 87068-8933 - Phone
- (505) 319-4246
- NPI assigned
- Jan 5, 2010
- 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 |
|---|---|---|---|
| 3769 | NM | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 3769 | NM | Yes |
Addresses
Primary practice location
635 Bosque Farms Blvd # 87068
1030 Stovall Ave Bosque Farms NM
Bosque Farms, NM 87068-8933
Mailing address
635 Bosque Farms Blvd Ste a
Bosque Farms, NM 87068-8933
Phone (505) 319-4246
Other providers in Bosque Farms, NM
- Pamela Fisher
- Lenora E Gerken
- Golden West Acupuncture and Wellness LLC.
- Tanya Gonzales
- James Edwin Gutierrez
- James Andrew Hatfield
- Health Quest Wellness Bosque, LLC
- Terry Henson
- Kellijo Jacobson
- Jade Marie Jamros
All providers in Bosque Farms, NM · Specialist 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 Oct 20, 2015. 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.