Adriene Harrelson

Individual provider Active NPI Licensed Practical Nurse · Santa Fe, NM

NPI 1871100537 · NPPES record last updated Sep 28, 2020

Key facts

NPI
1871100537
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
0002075858 (VA)
Practice address
1264 Rodeo Rd
Santa Fe, NM 87505-6816
Phone
(505) 982-2129
NPI assigned
Sep 28, 2020
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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
0002075858VAMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
New Mexico Treatment Services LLC Past
since Oct 4, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 0002075858 VA Yes

Addresses

Primary practice location

1264 Rodeo Rd
Santa Fe, NM 87505-6816

Mailing address

1264 Rodeo Rd
Santa Fe, NM 87505-6816
Phone (505) 982-2129

Other providers in Santa Fe, NM

All providers in Santa Fe, NM · Licensed Practical Nurse in New Mexico

Sources for this page

Verify at the official NPI Registry.