Nicole E Weiss
Individual provider Active NPI Massage Therapist · Edgewood, NM
NPI 1417732017 · NPPES record last updated Aug 30, 2023
Key facts
- NPI
- 1417732017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Massage Therapist 225700000X
- License
- 7861 (NM)
- Practice address
- 1 Linnie CT
Edgewood, NM 87015-9125 - Phone
- (505) 286-7838
- Fax
- (505) 286-8025
- NPI assigned
- Aug 30, 2023
- Sex
- Female
- Sole proprietor
- Yes
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7861 | NM | MD | Massage Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Active Solutions Therapy Serv Inc | Current |
Accepting new patients |
Locations
1 Linnie Ct
Edgewood, NM 87015
Phone (505) 286-7838
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 7861 | NM | Yes |
Addresses
Primary practice location
1 Linnie CT
Edgewood, NM 87015-9125
Mailing address
1 Linnie CT
Edgewood, NM 87015-9125
Phone (505) 286-7838
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- Chelsey Ann Weinbrecht
- Helen J. Weldon
- Melissa Rochelle Wheeler
- Raquel White
- Timothy A Winowich
- Jessica Wiseman
All providers in Edgewood, NM · Massage Therapist 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 Aug 30, 2023. 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.