Crockett, Telecia
Crockett, Telecia is an individual health care provider with primary practice located at 101 E Broadway Ave , Bloomfield NM 87413-6235. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Crockett, Telecia can be contacted via phone (505) 330-8220.Contact Information
Primary practice address
101 E Broadway Ave
Bloomfield NM 87413-6235
Phone: (505) 330-8220
Fax: (505) 234-7867
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1205425170 |
|---|---|
| LBN Legal business name | Crockett, Telecia |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 14th, 2021 |
| Last updated | Jan 19th, 2023 - about 3 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.
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