BERNADINE JOANN MEDINA


Address: 3001 Hotsprings Blvd, Las Vegas, NM 87701-2737
Phone: 5054256786

BERNADINE JOANN MEDINA (NPI# 1255595302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1255595302
Entity Type Individual
Full Name BERNADINE JOANN MEDINA
Practice Address 3001 Hotsprings Blvd
Las Vegas
NM 87701-2737
Mailing Address Po Box 2737
Las Vegas
NM 87701-2737
Practice Telephone 5054256786
Practice Fax Number 5054256787
Mailing Telephone 5054256786
Mailing Fax Number 5054256787
Enumeration Date 2008-07-17
Last Update Date 2008-07-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 101YA0400X Counselor
Specialization: Addiction (Substance Use Disorder)
0107321 NM Behavioral Health & Social Service Providers

Office Location

Street Address 3001 HOTSPRINGS BLVD
City LAS VEGAS
State NM
Zip Code 87701-2737

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Taxonomy Information

Taxonomy Code 101YA0400X
Grouping Behavioral Health & Social Service Providers
Classification Counselor
Specialization Addiction (Substance Use Disorder)

Taxonomy Definition

Definition to come...

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Competitor

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City LAS VEGAS
Zip Code 87701

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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