Basic Information
Provider Information
NPI: 1477975118
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ARMIJO
FirstName: SCHUYLER
MiddleName: P.
NamePrefix:  
NameSuffix:  
Credential: R.N.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: ARMIJO
OtherFirstName: SKY
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 5
Mailing Information
Address1: 505 S MAIN ST
Address2: SUITE 249
City: LAS CRUCES
State: NM
PostalCode: 880011206
CountryCode: US
TelephoneNumber: 5755275884
FaxNumber: 5755275886
Practice Location
Address1: 505 S MAIN ST
Address2: SUITE 249
City: LAS CRUCES
State: NM
PostalCode: 880011206
CountryCode: US
TelephoneNumber: 5755275884
FaxNumber: 5755275886
Other Information
ProviderEnumerationDate: 01/15/2014
LastUpdateDate: 01/15/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WS0200XR26764NMY Nursing Service ProvidersRegistered NurseSchool

No ID Information.


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