Mireles, Marcy Y

Mireles, Marcy Y is an individual health care provider with primary practice located at 5312 Rio Bravo Dr Ste 10 , Santa Teresa NM 88008-9210. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Mireles, Marcy Y can be contacted via phone (575) 915-1338.

Contact Information

Primary practice address
5312 Rio Bravo Dr Ste 10 Santa Teresa NM 88008-9210
Phone: (575) 915-1338
Fax: (575) 915-1819
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1538799804
LBN Legal business name Mireles, Marcy Y
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 24th, 2020
Last updated May 2nd, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1538799804 NPPES
New Mexico MEDICAID 41425260
New Mexico MEDICAID PENDING

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