Gregory Todd Eckstein, RN
Individual provider Active NPI School Registered Nurse · Bloomfield, NM
NPI 1316154982 · NPPES record last updated Jul 9, 2007
Key facts
- NPI
- 1316154982
- Entity type
- Individual (NPI type 1)
- Primary specialty
- School Registered Nurse 163WS0200X
- License
- R48383 (NM)
- Practice address
- 1201 N 1St St
Bloomfield, NM 87413-5271 - Phone
- (505) 634-3501
- Fax
- (505) 634-3584
- NPI assigned
- May 16, 2007
- 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
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R48383 | NM | MD | School Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Registered Nurse | 163WS0200X | R48383 | NM | Yes |
Addresses
Primary practice location
1201 N 1St St
Bloomfield, NM 87413-5271
Mailing address
1425 E Blanco Blvd
Bloomfield, NM 87413-6002
Phone (505) 634-3501
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64434826 | Medicaid | NM |
Other providers in Bloomfield, NM
- DHHS PHS Naihs Shiprock Hospital
- DHHS, PHS, Naihs, Shiprock Hospital
- DHHS, PHS, Naihs, Shiprock Hospital
- Victoria Dominguez
- David Lynn Doss
- Judy Linn Edwards
- Amy Elliott
- Mkayla Taylor Ellsworth
- Bernadette Diann Enriquez
- Marina B Ferrari
All providers in Bloomfield, 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 Jul 9, 2007. 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.