Randlemon, Annette
Randlemon, Annette is an individual health care provider with primary practice located at 2300 E 30Th St Bldg B, Suite 102, Farmington NM 87401-8990. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Randlemon, Annette can be contacted via phone (505) 324-1000.Contact Information
Primary practice address
2300 E 30Th St Bldg B, Suite 102
Farmington NM 87401-8990
Phone: (505) 324-1000
Fax: (505) 324-1199
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | R25038 | New Mexico |
Profile Details
| NPI number | 1366468159 |
|---|---|
| LBN Legal business name | Randlemon, Annette |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 14th, 2006 |
| Last updated | Jan 22nd, 2008 - about 16 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 | 1366468159 | NPPES |
| New Mexico | Other | 850462631 | STATE ID |
| New Mexico | Other | 850462631 | STATE ID |
| New Mexico | Other | 10002777 | STATE ID |
| New Mexico | Other | 201016092 | STATE ID |
| New Mexico | Other | 32D0943693 | STATE ID |
| New Mexico | MEDICAID | S3309 | STATE ID |
| New Mexico | Other | 400521029 | STATE ID |
| New Mexico | Other | NM006F13 | STATE ID |
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