MS. PRISCILLA T CARRILLO (NPI# 1922022995) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922022995 |
| Entity Type | Individual |
| Full Name | MS. PRISCILLA T CARRILLO |
| Credential | RN |
| Practice Address |
12000 Stone Lake Rd. Dulce NM 87528 |
| Mailing Address |
Hc 75 Box 53a Chama NM 87520-9702 |
| Practice Telephone | 5757593291 |
| Mailing Telephone | 5059294962 |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2010-09-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 163WP2201X |
Registered Nurse Specialization: Ambulatory Care |
R53479 | NM | Nursing Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NM | 00K3526 | 05 | |
| NM | MEDICARE PART B | HSZ196 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033640966 | Priscilla Carrillo | Case Manager/Care Coordinator | 3360 N Highway 59 Ste K, Merced, CA 95348-9405 | 2017-03-22 |
| 1649646563 | Priscilla Carrillo | Counselor | 770 Woodlane Rd, Westampton, NJ 08060-3804 | 2015-08-14 |
| Street Address |
12000 STONE LAKE RD. |
| City | DULCE |
| State | NM |
| Zip Code | 87528 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801803242 | Reyna R Garcia | Registered Nurse | 12000 Stone Lake Rd., Dulce, NM 87528-0392 | 2006-08-01 |
| 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 | 163WP2201X |
| Grouping | Nursing Service Providers |
| Classification | Registered Nurse |
| Specialization | Ambulatory Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760496673 | Nancy Jane Watts | Registered Nurse | 12000 Stone Lake, Dulce, NM 87528 | 2006-07-28 |
| 1629154562 | Margaret Jean Gillean | Registered Nurse | 12000 Stone Lake Road, Dulce, NM 87528 | 2006-10-31 |
| 1255347043 | Gaylia Dianne Pride | Registered Nurse | 12000 Stone Lake Rd, Dulce, NM 87528 | 2006-07-31 |
| 1467476440 | Susan Constance | Registered Nurse | 500 North Mundo, Dulce, NM 87528-0269 | 2006-07-26 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760036792 | Gina Marie Ruiz | Registered Nurse | 3777 Highway 528 Ne, Rio Rancho, NM 87144-7650 | 2019-07-29 |
| 1285122663 | Sabine Price | Registered Nurse | 8300 Constitution Pl Ne, Albuquerque, NM 87110-7637 | 2018-05-01 |
| 1457873382 | Cynthia Bluhm | Registered Nurse | 7600 Cedar St Se Ste 7600, Albuquerque, NM 87106 | 2017-07-12 |
| 1639619158 | Mary Ann Sedoskey | Registered Nurse | 1911 College Dr, Gallup, NM 87301-7010 | 2017-03-02 |
| 1881060903 | Jaime Brown | Registered Nurse | 2400 Unser Blvd. Se, Rio Rancho, NM 87124 | 2015-08-12 |
| 1902217466 | Ruth Chow | Registered Nurse | 5105 Glenwood Pointe Ln Ne, Albuquerque, NM 87111-2976 | 2014-05-17 |
| 1841529013 | Sherry Renea Wall | Registered Nurse | 1090 Goat Spring Road, Taos, NM 87571 | 2009-12-16 |
| 1245462100 | Gloria Fajardo | Registered Nurse | 909 Perry Meadows Dr Ne, Rio Rancho, NM 87144-7596 | 2009-08-11 |
| 1760613731 | Robyn Anne Elliott | Registered Nurse | 6909 Redondo Peak Rd Ne, Rio Rancho, NM 87144-6759 | 2009-08-07 |
| 1366673089 | Brenda Scott | Registered Nurse | 8404 Manuel Cia Pl Ne, Albuquerque, NM 87122-2813 | 2009-07-29 |
| 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.