Charlene Nicolette Gabaldon, RN

Individual provider Active NPI Hospice Registered Nurse · Isleta, NM

NPI 1811547995 · NPPES record last updated Oct 18, 2019

Key facts

NPI
1811547995
Entity type
Individual (NPI type 1)
Primary specialty
Hospice Registered Nurse 163WH1000X
License
R42860 (NM)
Practice address
01 Sagebrush
Isleta, NM 87022
Phone
(505) 869-3200
Fax
(505) 869-4881
NPI assigned
Sep 19, 2019
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
R42860NMMDHospice Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice Registered Nurse 163WH1000X R42860 NM Yes

Addresses

Primary practice location

01 Sagebrush
Isleta, NM 87022

Mailing address

PO Box 640
Isleta, NM 87022-0640
Phone (505) 869-4866

Other identifiers

IdentifierTypeStateIssuer
R42860OtherNMLICENSE

Other providers in Isleta, NM

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

Sources for this page

Verify at the official NPI Registry.