Valerie F Long, RN

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

NPI 1639272974 · NPPES record last updated Aug 13, 2008

Key facts

NPI
1639272974
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
103762 (CO)
Practice address
Dulce Health Center
12000 Stone Lake Road
Dulce, NM 87528-0187
Phone
(505) 759-3291
Fax
(505) 759-7289
NPI assigned
Sep 5, 2006
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
103762COMDDiabetes Educator Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Diabetes Educator Registered Nurse 163WD0400X 103762 CO
Community Health Registered Nurse 163WC1500X 103762 CO Yes

Addresses

Primary practice location

Dulce Health Center
12000 Stone Lake Road
Dulce, NM 87528-0187

Mailing address

PO Box 187
Dulce, NM 87528-0187
Phone (505) 759-3291

Other identifiers

IdentifierTypeStateIssuer
HSZ196OtherNMMEDICARE PART B
000K3526MedicaidNM

Other providers in Dulce, NM

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

Sources for this page

Verify at the official NPI Registry.