NORMA P GRANDBERRY


Address: 1501 Westchester St, Clovis, NM 88101-4638
Phone: 7572864505

NORMA P GRANDBERRY (NPI# 1740583350) 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) 1740583350
Entity Type Individual
Full Name NORMA P GRANDBERRY
Credential IDMT
Practice Address 1501 Westchester St
Clovis
NM 88101-4638
Practice Telephone 7572864505
Mailing Telephone 7572864505
Enumeration Date 2010-12-21
Last Update Date 2010-12-21
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 1710I1003X Military Health Care Provider
Specialization: Independent Duty Medical Technicians
Other Service Providers

Office Location

Street Address 1501 WESTCHESTER ST
City CLOVIS
State NM
Zip Code 88101-4638

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1134748692 Patrick James Scollon Military Health Care Provider 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 2020-04-14
1285274878 Keishla Cota Physical Therapist 100 East Manana Blvd, Unit 1, Clovis, NM 88101 2020-01-10
1659927283 Ndeye Ndour Nurse Anesthetist, Certified Registered 2100 N M.l.k. Jr Blvd, Clovis, NM 88101 2019-08-09
1679132468 Justine Nicole Nunez Nurse Practitioner 2301 North Doctor Martin Luther King Boulevard, Clovis, NM 88101 2019-06-06
1518453521 Moore Psychological Services, Pllc Social Worker 1908 West 21st Street, Clovis, NM 88101 2018-07-03
1912494006 Raesha Russell Behavior Technician 214 West 9th St, Clovis, NM 88101 2018-04-16
1013425800 Vanessa Yardley Registered Nurse 2100 N. Martin Luther King Jr. Blvd., Clovis, NM 88101 2018-01-16
1699204230 Olivia Garcia Technician, Other 1100 W 21st Street, Clovis, NM 88101 2017-06-07
1578006250 Mary Ellen Gray Technician, Other 9408 B Vermont Court, Clovis, NM 88101 2016-11-29
1205296977 Malaney Harmon Behavioral Analyst 2700 E 7th St., Clovis, NM 88101 2016-02-24
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Taxonomy Information

Taxonomy Code 1710I1003X
Grouping Other Service Providers
Classification Military Health Care Provider
Specialization Independent Duty Medical Technicians

Taxonomy Definition

An Independent Duty Medical Technician (IDMT) is specially trained and educated to perform primary medical care, minor surgical services, and treatment of dental disorders for active duty military members in a variety of health care and non-health care settings worldwide under direct and indirect physician supervision. An IDMT may take medical histories, perform physical exams, order lab tests and x-rays, prescribe medications, and give immunizations. IDMTs work under the direct supervision of a physician preceptor when at home station and indirectly when assigned to a Mobile Aid Station, Mobile Medical Unit, remote site, or otherwise deployed specifically as an IDMT. An IDMT may be an experienced Aerospace Medical Service Technician who meets special task qualifications and is recommended for training by the Aerospace Medical Service Functional Manager at their Medical Treatment Facility. IDMTs maintain certification as Nationally Registered Emergency Medical Technicians and as Immunization Back-up Technicians.
Notes: Source: Air Force Surgeon General Office [7/1/2005: new]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1144797556 William Murphy Whittle Military Health Care Provider 2000 Hallum St, Clovis, NM 88101-8684 2018-10-24
1265983068 Yurikoaokio Motomochi Livas Military Health Care Provider 209 Wilmington Cir, Clovis, NM 88101-9382 2016-10-18
1831438357 John Frederick Rinaldi Military Health Care Provider 3500 Adenmore Ct, Apt C, Clovis, NM 88101 2013-02-04
1609186139 Jeramy Byrd Military Health Care Provider 9410 A Vermont Court, Clovis, NM 88101 2010-10-18
1477879708 Christopher Gordon Brown Military Health Care Provider 717 Sandia Dr, Clovis, NM 88101-4123 2010-04-12
1396989968 Luis Alberto Hallman Military Health Care Provider 3516 Adenmor Ct, Unit B, Clovis, NM 88101-2820 2009-04-28
1689271736 Sinead Catherine Brosnan Military Health Care Provider 208 D L Ingram Ave W, Clovis, NM 88103-5103 2020-10-01
1801132220 Dena Levari Military Health Care Provider 208 W Casablanca Ave, Clovis, NM 88103-5009 2012-12-13
1245474667 Daniel Lewis Tyson Military Health Care Provider 208 W Casablanca Ave, Clovis, NM 88103-5009 2009-04-29

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1801496625 Stephen Kreidler Military Health Care Provider 5453 Roosevelt Loop Ne, Rio Rancho, NM 87144-5218 2020-10-30
1134748692 Patrick James Scollon Military Health Care Provider 104 W D. L. Ingram Ave, Cannon Afb, Nm 88101, Cannon Afb, NM 88101 2020-04-14
1245614544 Rowland Coyle Military Health Care Provider 701 Stephen Moody Rd, Albuquerque, NM 87117 2015-07-16
1972939585 Eugene Navarro Tabita Military Health Care Provider 4050a Greenhouse Pl Se, Albuquerque, NM 87116-3008 2013-09-16
1043553217 Amanda Colyer Military Health Care Provider 2050 2nd St Se # A, Albuquerque, NM 87117-5522 2013-04-05
1003176389 Ricky Franco Vela Military Health Care Provider 8101a W Sandia Cir Se, Albuquerque, NM 87116-5501 2012-05-21
1194041426 Philip Ofimiano Borde Jr. Military Health Care Provider 4660 Mesa Rico Dr, Las Cruces, NM 88011-7228 2010-04-12
1285958017 Michael Wayne Mcfadden Military Health Care Provider 2309 Saguaro Loop, Alamogordo, NM 88310-7775 2010-03-23
1952630642 Michael B Stull Military Health Care Provider 904 S Dallas Ave Apt 3, Portales, NM 88130-6028 2009-12-09
1598909012 Martin Oleen Jensen Military Health Care Provider 119 E Arcadia Ave Bldg 622, 27 Special Operations Support Sqdn/osm, Cannon Afb, NM 88103-5112 2009-04-28
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Competitor

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City CLOVIS
Zip Code 88101

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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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