Cheryl Hare, LPN
Individual provider Active NPI Licensed Practical Nurse · Bloomfield, NM
NPI 1730637117 · NPPES record last updated Sep 14, 2016
Key facts
- NPI
- 1730637117
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Licensed Practical Nurse 164W00000X
- License
- L17275 (NM)
- Practice address
- 325 N Bergin LN
Bloomfield, NM 87413-6729 - Phone
- (505) 632-4389
- Fax
- (505) 213-0007
- NPI assigned
- Sep 14, 2016
- 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
| License | State | Type | Specialty |
|---|---|---|---|
| L17275 | NM | MD | Licensed Practical Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | L17275 | NM | Yes |
Addresses
Primary practice location
325 N Bergin LN
Bloomfield, NM 87413-6729
Mailing address
325 N Bergin LN
Bloomfield, NM 87413-6729
Phone (505) 632-4389
Other providers in Bloomfield, NM
- Andrea Gonzales
- James B Guynn
- William R Hall
- Lisa Hamilton
- Bryan Wayne Harber
- Douglas K Harris
- Kathleen Henderson
- Christina L Herbig
- Connie Hernandez
- Roy Hernandez
All providers in Bloomfield, NM · Licensed Practical Nurse 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 Sep 14, 2016. 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.