DESERT BLOOM TELEPSYCH SERVICES LLC (NPI# 1336503176) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1336503176 |
Entity Type | Organization |
Organization Name | DESERT BLOOM TELEPSYCH SERVICES LLC |
Practice Address |
8605 Vineyard Ridge Rd Ne Albuquerque NM 87122-2623 |
Practice Telephone | 5056206389 |
Mailing Telephone | 5056206389 |
Enumeration Date | 2016-04-07 |
Last Update Date | 2016-04-07 |
Authorized Official Name | DEBRA MARIE STANGER (PMHNP-BC SOLE OWNER) |
Authorized Official Telephone | 5058562262 |
Authorized Official Credential | CNP |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
CNP-01597 | NM | Physician Assistants & Advanced Practice Nursing Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | 78935784 | 05 |
Street Address |
8605 VINEYARD RIDGE RD NE |
City | ALBUQUERQUE |
State | NM |
Zip Code | 87122-2623 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1932372935 | Debra Stanger | Registered Nurse | 8605 Vineyard Ridge Rd Ne, Albuquerque, NM 87122-2623 | 2008-04-10 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1700426988 | Sophia Khalil | Student in an Organized Health Care Education/Training Program | 11128 Jordan Avenue Northeast, Albuquerque, NM 87122 | 2020-01-15 |
1457716664 | Raymond Martinez | Pharmacist | 7847 Tramway Ne, Albuquerque, NM 87122 | 2015-12-15 |
1891181913 | Paul Wright | Occupational Therapist | 30 Canocito Drive Ne, Albuquerque, NM 87122 | 2015-04-15 |
1356736615 | Tracy Pfeifer | Day Training/Habilitation Specialist | 8920 Holly Avenue Ne, Suite 102b, Albuquerque, NM 87122 | 2015-04-03 |
1346595071 | Jonathan Harper Kelley | Dentist | 9015 Paseo Del Norte Ne Ste A, Albuquerque, NM 87122 | 2012-07-18 |
1639444946 | Charlsey Leigh Mcdonald | Physical Therapist | 7920 Carmel Ave. Ne, Suite 2, Albuquerque, NM 87122 | 2012-03-20 |
1235462250 | Pamela Kay Limke | Pharmacist | 12112 Summer Wind Pl Ne, Albuquerque, NM 87122 | 2009-09-09 |
1437395332 | High Desert Pedicatrics PC | Pediatrics | 8650 Almeda Boulevard, Ne, Unit 101 E, Albuquerque, NM 87122 | 2008-12-23 |
1952427510 | Thomas Harry Heflin | Dentist | 8000 Carmel Ave, Albuquerque, NM 87122 | 2007-03-22 |
1497885032 | Thomas H Heflin Dds Pa | Dentist | 8000 Carmel Avenue Ne, Albuquerque, NM 87122 | 2007-03-06 |
Find all providers in zip 87122 |
Taxonomy Code | 363LP0808X |
Grouping | Physician Assistants & Advanced Practice Nursing Providers |
Classification | Nurse Practitioner |
Specialization | Psych/Mental Health |
Definition to come... |
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1013524727 | Clarissa Juarez, LLC | Nurse Practitioner | 3900 Juan Tabo Blvd Ne Ste 4, Albuquerque, NM 87111-3978 | 2020-09-26 |
1053933721 | Canu Health, LLC | Nurse Practitioner | 2621 Cutler Ave Ne, Albuquerque, NM 87106-2511 | 2020-05-15 |
1245869130 | Indigo Psychiatric Services | Nurse Practitioner | 609 Gold Ave Sw Ste 1-c, Albuquerque, NM 87102-3119 | 2020-04-03 |
1194388496 | Anne E. Galanis | Nurse Practitioner | 100 Deputy Dean Miera Dr Sw: Bernalillo County Metropol, Albuquerque, NM 87151 | 2019-04-22 |
1790214344 | La Paloma Clinic LLC | Nurse Practitioner | 431 Gene Ave Nw, Albuquerque, NM 87107-5320 | 2017-06-07 |
1437493020 | Sarah Michael Workman | Nurse Practitioner | 1501 San Pedro Drive Se, Bld 47, 377mdg/mdos/sgow, Albuquerque, NM 87117 | 2012-11-20 |
1437407301 | Jayanna Warwick | Nurse Practitioner | 2015 Wyoming Blvd Ne, Suite F, Albuquerque, NM 87112-2622 | 2012-08-26 |
1780939975 | Brenda Kaye Mckenna | Nurse Practitioner | Unm Department of Psychiatry and Behavioral Health Scie, 1 University of New Mexico, Albuquerque, NM 87131 | 2012-07-13 |
1194091603 | Awareness Integration LLC | Nurse Practitioner | 219 Sierra Dr Se, Unit A, Albuquerque, NM 87108-2714 | 2012-03-29 |
1003148156 | Maureen Kolomeir | Nurse Practitioner | 5345 Wyoming Blvd, Suite 101, Albuquerque, NM 87109-3193 | 2010-01-30 |
Find all providers in ALBUQUERQUE |
City | ALBUQUERQUE |
Zip Code | 87122 |
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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.