Annie Felicia Coots, RN

Individual provider Active NPI Community Health Registered Nurse · Isleta, NM

NPI 1376819680 · NPPES record last updated Mar 30, 2012

Key facts

NPI
1376819680
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
R07243 (NM)
Practice address
01 Sagebrush
Isleta, NM 87022-0640
Phone
(505) 869-3200
Fax
(505) 869-4881
NPI assigned
Mar 30, 2012
Sex
Female
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

LicenseStateTypeSpecialty
R07243NMMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R07243 NM Yes

Addresses

Primary practice location

01 Sagebrush
Isleta, NM 87022-0640

Mailing address

P.O Box 640
Isleta, NM 87022-0640
Phone (505) 869-3200

Other providers in Isleta, NM

All providers in Isleta, NM · Community Health Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.