Lois Coomer

Individual provider Active NPI Registered Nurse · Isleta, NM

NPI 1477964419 · NPPES record last updated May 13, 2014

Key facts

NPI
1477964419
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
R44523 (NM)
Practice address
01 Sagebrush Street
Isleta, NM 87022
Phone
(505) 869-4874
NPI assigned
May 13, 2014
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

State licenses

LicenseStateTypeSpecialty
R44523NMMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X R44523 NM Yes

Addresses

Primary practice location

01 Sagebrush Street
Isleta, NM 87022

Mailing address

PO Box 640
Isleta, NM 87022-0640
Phone (505) 869-4874

Other identifiers

IdentifierTypeStateIssuer
R44523OtherNMRN LICENSE

Other providers in Isleta, NM

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

Sources for this page

Verify at the official NPI Registry.