Debra Anne Carlisle, RD, LD, MS
Individual provider Active NPI Registered Dietitian · Raton, NM
NPI 1497974117 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1497974117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- LD 0657 (NM)
- Practice address
- 200 Hospital Dr
Raton, NM 87740-2013 - Phone
- (505) 445-7726
- Fax
- (505) 445-7708
- NPI assigned
- Apr 24, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LD 0657 | NM | MD | Registered Dietitian |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | LD 0657 | NM | Yes |
Addresses
Primary practice location
200 Hospital Dr
Raton, NM 87740-2013
Mailing address
31191 Hwy 64
PO Box 495
Cimarron, NM 87714
Phone (505) 376-2333
Other providers in Raton, NM
- Sheila Brooks
- Michael Lynn Brown
- Kayce L Bustos
- Charles James Buttram Jr.
- Cardinal Path Wellness LLC
- Tanaye Marie Carroll-Maez
- Anna Caruana
- Lee C Caruana
- Connie Casias
- Casita Alegra LLC
All providers in Raton, NM · Registered Dietitian 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 8, 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.