MS. STELLA ELIZABETH WILSON (NPI# 1891085262) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1891085262 |
Entity Type | Individual |
Full Name | MS. STELLA ELIZABETH WILSON |
Credential | M.T. |
Practice Address |
500 Stone Lake Road Dulce NM 87528 |
Practice Telephone | 5757597309 |
Practice Fax Number | 5757597294 |
Mailing Telephone | 5757597309 |
Mailing Fax Number | 5757597294 |
Enumeration Date | 2011-04-19 |
Last Update Date | 2012-06-13 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 246QM0706X |
Spec/Tech, Pathology Specialization: Medical Technologist |
TN 26432 | FL | Technologists, Technicians & Other Technical Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
NM | MEDICARE PART B | HSZ196 | 01 |
NM | K3526 | 05 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1831621705 | Stella Wilson I | Developmental Therapist | 345a Greenwood Street, Suit B, Worcester, MA 01607 | 2017-03-30 |
1598196636 | Stella Wilson | Social Worker | 1786 Moon Lake Blvd, Suite 104, Hoffman Estates, IL 60169-5029 | 2013-11-27 |
Street Address |
500 STONE LAKE ROAD |
City | DULCE |
State | NM |
Zip Code | 87528 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1164917373 | Kelly Rae Pettigrew | Optometrist | 505 North Mundo, Dulce, NM 87528 | 2018-06-29 |
1780003442 | Jacob Alexander | Preventive Medicine | 500 N. Mundo, Dulce, NM 87528 | 2014-04-09 |
1881020089 | Jicarilla Apache Nation | Clinic/Center | 450 N Mundo Dr., Dulce, NM 87528 | 2013-09-19 |
1285971515 | Samuel Taylor Cropp | Pharmacist | 500 N Mundo Dr, Dulce, NM 87528 | 2013-01-07 |
1720331697 | Northwest Reional Education Coop #2 | Student in an Organized Health Care Education/Training Program | 91 Hawk Drive, Dulce, NM 87528 | 2012-10-17 |
1306116066 | Michael Shawn Kennedy | Psychologist | 113 Hawk Dr, Dulce, NM 87528 | 2012-01-11 |
1669762043 | Veronica A Medlin | Technician, Pathology | 1200 Stone Lake Rd, Dulce, NM 87528 | 2011-04-19 |
1134419518 | Ray Morris Joe | Technician, Pathology | 500 North Mundo Road, Dulce, NM 87528 | 2011-04-19 |
1801186341 | Raquel Irene Cisneros | Family Medicine | 500 N. Mundo Dr., Dulce, NM 87528 | 2011-04-18 |
1285823435 | Karen Keating | Counselor | 26 Narrow Gauge Dr., Dulce, NM 87528 | 2007-10-23 |
Find all providers in zip 87528 |
Taxonomy Code | 246QM0706X |
Grouping | Technologists, Technicians & Other Technical Service Providers |
Classification | Spec/Tech, Pathology |
Specialization | Medical Technologist |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1508138660 | Marie Tallent Deloach | Spec/Tech, Pathology | 500 North Mundo, Dulce, NM 87528 | 2012-02-06 |
1487805198 | Anna V. Hall | Spec/Tech, Pathology | 12000 Stone Lake Road, Dulce, NM 87528-0187 | 2008-10-01 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1629600556 | Ruben Costales Nanez | Spec/Tech, Pathology | 661 Wendy Ln, Las Cruces, NM 88007-5324 | 2020-02-09 |
1427348051 | Ronald Valer Marmash | Spec/Tech, Pathology | 3113 Britt St Ne, Albuquerque, NM 87111-4954 | 2011-04-16 |
1639399967 | Patrick Norman Vigil II | Spec/Tech, Pathology | 318 Abalone Loop Rd, Mescalero, NM 88340 | 2007-04-27 |
1609935931 | Suzanna Duran | Spec/Tech, Pathology | 318 Abalone Loop, Mescalero, NM 88340 | 2006-12-06 |
1376638411 | Vicky L Sparks Freeman | Spec/Tech, Pathology | 1090 Goat Springs Road, Taos Picuris Indian Health Center, Taos, NM 87571 | 2006-10-04 |
Please comment or provide details below to improve the information on MS. STELLA ELIZABETH WILSON.
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.