Marlon Caballero, RN, BSN
Individual provider Active NPI Critical Care Medicine Registered Nurse · Gallup, NM
NPI 1154665222 · NPPES record last updated Nov 15, 2012
Key facts
- NPI
- 1154665222
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Critical Care Medicine Registered Nurse 163WC0200X
- License
- R182515 (MD)
- Practice address
- 516 E Nizhoni Blvd
Gallup, NM 87301-5748 - Phone
- (505) 722-1000
- NPI assigned
- Nov 15, 2012
- 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
- Credentials
- Bachelor on Science - Nursing, Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R182515 | MD | MD | Critical Care Medicine Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Critical Care Medicine Registered Nurse | 163WC0200X | R182515 | MD | Yes |
Addresses
Primary practice location
516 E Nizhoni Blvd
Gallup, NM 87301-5748
Mailing address
401 S First St
Gallup, NM 87301-6213
Phone (410) 963-6322
Other providers in Gallup, NM
- William Anthony Burrola
- Julie R Bussewitz
- Alice Bybee
- Kristopher Charles Byman
- Flor J. Caballar Gonzaga
- Lorraine Amanda Cabrillas
- Cactus Medical Transit
- Michael Cadieux
- William Bruce Cage
- Shawn Calavaza
All providers in Gallup, NM · Critical Care Medicine 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 Nov 15, 2012. 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.