Denise Marie Fallwell, CNP

Individual provider Active NPI Registered Nurse · El Rito, NM

NPI 1437113545 · NPPES record last updated Feb 3, 2010

Key facts

NPI
1437113545
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R40330 (NM)
Practice address
Hwy 571 #28
El Rito, NM 87530
Phone
(505) 581-4728
NPI assigned
Apr 14, 2006
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R40330NMMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Group Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R40330 NM Yes

Addresses

Primary practice location

Hwy 571 #28
El Rito, NM 87530

Mailing address

PO Box 129
El Rito, NM 87530-0129
Phone (505) 581-4728

Other providers in El Rito, NM

All providers in El Rito, NM · Registered Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.