Victoria Jewel Abraham

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Portales, NM

NPI 1952964017 · NPPES record last updated Apr 15, 2019

Key facts

NPI
1952964017
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1500 South Ave K
Station 3 Shroc
Portales, NM 88130
Phone
(800) 367-3668
NPI assigned
Apr 15, 2019
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

Practice roles

OrganizationSpecialtyStatusNew patients
Eastern New Mexico University Past
since Nov 12, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1500 South Ave K
Station 3 Shroc
Portales, NM 88130

Mailing address

1500 S Avenue K
Station 3 Shroc
Portales, NM 88130-7400

Other providers in Portales, NM

All providers in Portales, NM · Student in an Organized Health Care Education/Training Program in New Mexico

Sources for this page

Verify at the official NPI Registry.