MS. MARIE TALLENT DELOACH (NPI# 1508138660) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508138660 |
| Entity Type | Individual |
| Full Name | MS. MARIE TALLENT DELOACH |
| Credential | MT(ASCP) |
| Practice Address |
500 North Mundo Dulce NM 87528 |
| Mailing Address |
Po Box 187 500 North Mundo Dulce NM 87528-0187 |
| Practice Telephone | 5757597252 |
| Practice Fax Number | 5757593532 |
| Mailing Telephone | 5757597252 |
| Mailing Fax Number | 5757593532 |
| Enumeration Date | 2012-02-06 |
| Last Update Date | 2012-02-06 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 246QM0706X |
Spec/Tech, Pathology Specialization: Medical Technologist |
03671395 | SC | Technologists, Technicians & Other Technical Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 000K3526 | 05 | |
| NM | MEDICARE PART B | HSZ196 | 01 |
| Street Address |
500 NORTH MUNDO |
| City | DULCE |
| State | NM |
| Zip Code | 87528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750388963 | Dulce Health Center | Clinic/Center | 500 North Mundo, Dulce, NM 87528-0187 | 2005-07-01 |
| 1134490790 | Phyllis Diane Morehead | Registered Nurse | 500 North Mundo, Dulce, NM 87528-0187 | 2012-01-13 |
| 1043594906 | Sonja H Emerson | Registered Nurse | 500 North Mundo, Dulce, NM 87528-0187 | 2011-10-10 |
| 1013215813 | Deanna S Iovine | Registered Nurse | 500 North Mundo, Dulce, NM 87528 | 2011-03-03 |
| 1548437338 | Bichson Pham | Family Medicine | 500 North Mundo, Dulce, NM 87528-7418 | 2008-05-12 |
| 1902079411 | Lydia Ann Stinemeyer | Registered Nurse | 500 North Mundo, Jicarilla Indian Health Service Clinic, Dulce, NM 87528 | 2008-04-04 |
| 1265591606 | Steven John Petrakis | Family Medicine | 500 North Mundo, Dulce, NM 87528-2725 | 2006-12-08 |
| 1144323353 | Jennifer Lea Lea Claycomb | Family Medicine | 500 North Mundo, Dulce, NM 87528-0187 | 2006-09-06 |
| 1356358881 | Marie S March | Registered Nurse | 500 North Mundo, Dulce, NM 87528 | 2006-08-01 |
| 1467476440 | Susan Constance | Registered Nurse | 500 North Mundo, Dulce, NM 87528-0269 | 2006-07-26 |
| Find all providers in the same location | ||||
| 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 |
| 1891085262 | Stella Elizabeth Wilson | Spec/Tech, Pathology | 500 Stone Lake Road, 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 |
| 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 |
|---|---|---|---|---|
| 1891085262 | Stella Elizabeth Wilson | Spec/Tech, Pathology | 500 Stone Lake Road, Dulce, NM 87528 | 2011-04-19 |
| 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. MARIE TALLENT DELOACH.
| 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.