Basic Information
| Provider Information | |||||||||
| NPI: | 1568621324 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | STATS | ||||||||
| FirstName: | ANNE | ||||||||
| MiddleName: | T | ||||||||
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| Credential: | RN | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2600 MARBLE, RRP CLINIC | ||||||||
| Address2: | MENTAL HEALTH CENTER, UNMH | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871315426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052722800 | ||||||||
| FaxNumber: | 5052729843 | ||||||||
| Practice Location | |||||||||
| Address1: | 2600 MARBLE, RRP CLINIC | ||||||||
| Address2: | MENTAL HEALTH CENTER, UNMH | ||||||||
| City: | ALBUQUERQUE | ||||||||
| State: | NM | ||||||||
| PostalCode: | 871315426 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5052722800 | ||||||||
| FaxNumber: | 5052729843 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2008 | ||||||||
| LastUpdateDate: | 11/01/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 163WP0809X | RN-76277 | NM | Y | Nursing Service Providers | Registered Nurse | Psych/Mental Health, Adult |
No ID Information.