Deale, Regina
Deale, Regina is an individual health care provider with primary practice located at 2015 E 12Th St , Farmington NM 87401-7460. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Deale, Regina can be contacted via phone (505) 326-2695.Contact Information
Primary practice address
2015 E 12Th St
Farmington NM 87401-7460
Phone: (505) 326-2695
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
NPI number | 1417359175 |
---|---|
LBN Legal business name | Deale, Regina |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Sep 24th, 2014 |
Last updated | Sep 24th, 2014 - about 11 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 | 1417359175 | NPPES |
New Mexico | MEDICAID | 174V00000X |
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