REVITALIZED NATURAL HEALTH CENTER (NPI# 1205139805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205139805 |
| Entity Type | Organization |
| Organization Name | REVITALIZED NATURAL HEALTH CENTER |
| Practice Address |
720 Lamp Post Cir Se Albuquerque NM 87123-4115 |
| Practice Telephone | 5052931658 |
| Practice Fax Number | 5052984737 |
| Mailing Telephone | 5052931658 |
| Mailing Fax Number | 5052984737 |
| Enumeration Date | 2010-12-21 |
| Last Update Date | 2016-03-25 |
| Authorized Official Name | MRS. PHILOMENA E MARCUS (OWNER) |
| Authorized Official Telephone | 5052931658 |
| Authorized Official Credential | CFNP |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
R25188 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 94108897 | 05 | |
| NM | BCBS OF NM | NM00RH90 | 01 |
| Street Address |
720 LAMP POST CIR SE |
| City | ALBUQUERQUE |
| State | NM |
| Zip Code | 87123-4115 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497360291 | Frances J. Dewent | Technician | 504 Aragon St Se, Albuquerque, NM 87123 | 2020-09-09 |
| 1275042293 | Amanda Valdez-androlewicz | Nurse Practitioner | 1117 Monte Largo Dr Ne, Albuquerque, NM 87123 | 2017-09-21 |
| 1740708809 | 11.11, LLC | Case Manager/Care Coordinator | 11724 Copper Pl Ne, Albuquerque, NM 87123 | 2017-09-08 |
| 1710375365 | Diane Crouse | Occupational Therapist | 820 Monte Alto Dr Ne, Albuquerque, NM 87123 | 2015-01-06 |
| 1346640760 | Christopher Trout | Physical Therapist | 11419 Deer Lodge Rd Se, Albuquerque, NM 87123 | 2014-09-04 |
| 1255682944 | Armstrong Medical LLC | Physician Assistant | 13170 Central Ave Se, Suite B 345, Albuquerque, NM 87123 | 2012-09-21 |
| 1467709006 | Tomas Maestas | Emergency Medical Technician, Paramedic | 1515 Eubank Blvd Se Bldg. 831/832, Albuquerque, NM 87123 | 2012-08-14 |
| 1831476951 | Shellie Nicole Field | Pharmacist | 1515 Eubank Se, Bldg 831 Rm 143, Albuquerque, NM 87123 | 2011-11-03 |
| 1023325768 | Moss Trompeter | Pharmacist | 1931 Cam Fella St Se, Albuquerque, NM 87123 | 2010-09-01 |
| 1114239522 | Miguel A. Perez Abreu | Preventive Medicine | 600 Wyoming Blvd Ne, Albuquerque, NM 87123 | 2010-07-14 |
| Find all providers in zip 87123 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536545 | Eglis Jane Pereyra | Nurse Practitioner | 5720 Lost Dutchman St Ne, Albuquerque, NM 87111-5903 | 2020-10-19 |
| 1467061895 | Bruna Brum Wynne | Nurse Practitioner | 933 Bradbury Dr Se Ste 2204, Albuquerque, NM 87106-4375 | 2020-07-31 |
| 1811522238 | Oso Medical Group, LLC | Nurse Practitioner | 2441 Menaul Blvd Ne, Albuquerque, NM 87107-1823 | 2020-03-05 |
| 1417595562 | Brandy Renee Chavez | Nurse Practitioner | 12205 Palm Springs Ave Ne, Albuquerque, NM 87111-5421 | 2019-12-18 |
| 1598307530 | Audrey R Clark | Nurse Practitioner | 7936 Brady Rd Nw, Albuquerque, NM 87120-1246 | 2019-10-10 |
| 1376058099 | Michael M Archuleta | Nurse Practitioner | 7912 Teaberry Rd Nw, Albuquerque, NM 87120-5275 | 2017-12-04 |
| 1811349194 | Tiffany Nicole Grant | Nurse Practitioner | 1501 San Pedro Dr Se Ste 111, Albuquerque, NM 87108-5180 | 2016-07-11 |
| 1093115271 | Maria De La Luz Nicole Webb | Nurse Practitioner | 2211 Lomas Blvd. Ne 2nd Floor, University of New Mexico Surgical Specialties Clinic, Albuquerque, NM 87106 | 2014-08-26 |
| 1891123485 | William Finley | Nurse Practitioner | Unmh Doim Cardiology Division, Msc 10 5550, Albuquerque, NM 87131-0001 | 2013-10-17 |
| 1780979278 | Maria Retunski | Nurse Practitioner | 10600 Royal Birkdale Ne, Unm Hospital, Department of Neurosurgery, Albuquerque, NM 87111-6571 | 2011-06-13 |
| Find all providers in ALBUQUERQUE | ||||
| City | ALBUQUERQUE |
| Zip Code | 87123 |
Please comment or provide details below to improve the information on REVITALIZED NATURAL HEALTH CENTER.
| 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.