Anne Katharina Deberry
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Portales, NM
NPI 1164053070 · NPPES record last updated Jan 29, 2020
Key facts
- NPI
- 1164053070
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 1500 S Ave K
Station 3, Shroc
Portales, NM 88130 - Phone
- (575) 562-2156
- NPI assigned
- Jan 29, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eastern New Mexico University | Current |
Accepting new patients |
Locations
1500 S Avenue K
#3
Portales, NM 88130
Phone (575) 562-2156
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Yes |
Addresses
Primary practice location
1500 S Ave K
Station 3, Shroc
Portales, NM 88130
Mailing address
1500 S Ave K
Station 3, Shroc
Portales, NM 88130
Other providers in Portales, NM
- Nicole Ashley Craig
- Sarah Cuyzon
- Prisma Davalos
- Emily Davis
- Samantha Kaye Davis
- Ileana Dennis
- Taylor Raye Dennis
- Dental Designs, PC
- Desert Sands Mental Health and Play Therapy LLC
- Rebecca Kaci Dewbre
All providers in Portales, NM · Student in an Organized Health Care Education/Training Program 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 Jan 29, 2020. 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.