Archuleta, Nicole Camille
Archuleta, Nicole Camille is an sole proprietor health care provider with primary practice located at 1227 N Railroad Ave Ste C , Espanola NM 87532-3159. She recently has only one registered license in Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), which is considered as her primary health care specialty. Archuleta, Nicole Camille can be contacted via phone (505) 747-8187.Contact Information
Primary practice address
1227 N Railroad Ave Ste C
Espanola NM 87532-3159
Phone: (505) 747-8187
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 0178081 | New Mexico |
Profile Details
| NPI number | 1720580681 |
|---|---|
| LBN Legal business name | Archuleta, Nicole Camille |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 6th, 2018 |
| Last updated | Mar 6th, 2018 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720580681 | NPPES |
| New Mexico | MEDICAID | 1265683049 |
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