OLOWAN D DEHERRERA (NPI# 1447410196) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1447410196 |
| Entity Type | Individual |
| Full Name | OLOWAN D DEHERRERA |
| Credential | RN |
| Practice Address |
I-40 Exit 102 Acl Phs Indian Hospital San Fidel NM 87049-0130 |
| Mailing Address |
Po Box 130 San Fidel NM 87049-0130 |
| Practice Telephone | 5055525324 |
| Practice Fax Number | 5055525490 |
| Mailing Telephone | 5055525324 |
| Mailing Fax Number | 5055525490 |
| Enumeration Date | 2008-06-16 |
| Last Update Date | 2008-06-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WC1500X |
Registered Nurse Specialization: Community Health |
R64117 | NM | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | NURSING | R64117 | 01 |
| Street Address |
I-40 EXIT 102 ACL PHS INDIAN HOSPITAL |
| City | SAN FIDEL |
| State | NM |
| Zip Code | 87049-0130 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851584213 | Melissa Y Wyaco | Registered Nurse | I-40 Exit 102, San Fidel, NM 87049-0130 | 2007-08-20 |
| 1114251568 | Jennifer Jeanne Lyon | Pharmacist | I-40 Exit 102, San Fidel, NM 87049 | 2009-10-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669937074 | James Blythe | Pharmacist | 80 Veterens Blvd, Acoma, NM 87049 | 2019-02-11 |
| 1689185571 | Jullliene Reed-tso | Social Worker | New Sunrise Rtc 20 Mockingbird Drive, San Fidel, NM 87049 | 2017-10-18 |
| 1245635309 | Donna Enfield | Counselor | Exit 102 1/2 Mi S of I-40, San Fidel, NM 87049 | 2014-10-30 |
| 1336425826 | Jodi Gee | Pharmacist | Acl Hospital Pharmacy Dept. I-40 @ Exit 102 (acomita), San Fidel, NM 87049 | 2011-10-27 |
| 1659528354 | Elaine Little | Dietitian, Registered | Acl Phs Indian Hospital, I - 40 Exit 102, San Fidel, NM 87049 | 2008-08-25 |
| 1366612830 | Lisa Ann Cohn | Pharmacist | Interstate 40 @ Exit 102, Acl Hospital Pharmacy Dept, San Fidel, NM 87049 | 2008-03-11 |
| 1619182821 | Melissa M Salinas | Physician Assistant | Exit 102 Off I-40 Half Mile S, San Fidel, NM 87049 | 2007-05-11 |
| 1083828453 | Edwina Faye Lee | Dental Hygienist | Exit 102 Off I40, 1/2 Mi South, San Fidel, NM 87049 | 2007-05-09 |
| 1730200171 | Carol Rose Cummins | Pharmacist | Interstate 40 Exit 102, San Fidel, NM 87049 | 2007-04-03 |
| 1881727873 | Acoma Canoncito Laguna Ihs Pharmacy | Pharmacy | 1 40 Exit 203 Acomita, San Fidel, NM 87049 | 2007-03-13 |
| Find all providers in zip 87049 | ||||
| Taxonomy Code | 163WC1500X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Community Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053504852 | Marina Veit | Registered Nurse | Exit 102 Off I-40 1/2 Mi South, San Fidel, NM 87049-0130 | 2007-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982185948 | Trinity Christian Camps, Ltd | Registered Nurse | 1698 S Roosevelt Road 13, Portales, NM 88130-8705 | 2018-08-27 |
| 1841796224 | Patricia Mccarty | Registered Nurse | 49 Twin Peaks Rd Se, Albuquerque, NM 87123-3906 | 2018-04-03 |
| 1326548355 | Dana Tapia | Registered Nurse | 49 Camino La Canada, Los Lunas, NM 87031-8177 | 2018-02-16 |
| 1730691742 | Larissa Baldonado | Registered Nurse | 236 Don Pasqual Rd Nw, Los Lunas, NM 87031 | 2017-10-31 |
| 1639579352 | Cynthia Brooks | Registered Nurse | 85 West Highway 22 Santo Domingo Health Center, Santo Domingo, NM 87052 | 2014-08-29 |
| 1457698714 | Diane M Broome | Registered Nurse | 11a Leaping Powder Rd, Santa Fe, NM 87508-5923 | 2013-01-07 |
| 1588948905 | Catherine Mary Yarmey-legg | Registered Nurse | 1621 Saratoga Dr Ne, Rio Rancho, NM 87144-1511 | 2011-10-04 |
| 1043535388 | Pearl A Alonzo | Registered Nurse | Bia 125, Pine Hill Health Center, Pine Hill, NM 87357 | 2010-03-30 |
| 1023137155 | Cynthia Fraser | Registered Nurse | 516 Nizhoni Boulevard, Bldg. F, Gimc, Phn, Gallup, NM 87301 | 2007-03-28 |
| 1194802017 | James Lee Sutton | Registered Nurse | Jicarilla Health Care Facility, 12000 Stone Lake Rd, Pob 187, Dulce, NM 87528 | 2006-11-01 |
| Find all providers with the same taxonomy | ||||
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| 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.