Riedel, Elizabeth J
Riedel, Elizabeth J is an individual health care provider with primary practice located at 1111 El Llano Rd , Espanola NM 87532-6727. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Riedel, Elizabeth J can be contacted via phone (505) 929-1629.Contact Information
Primary practice address
1111 El Llano Rd
Espanola NM 87532-6727
Phone: (505) 929-1629
Fax: (505) 753-5815
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 77-PA007 | New Mexico |
Profile Details
| NPI number | 1891788253 |
|---|---|
| LBN Legal business name | Riedel, Elizabeth J |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 31st, 2005 |
| Last updated | Jul 1st, 2013 - 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 | 1891788253 | NPPES |
| New Mexico | Other | NM400315 | MEDICARE PTAN |
| New Mexico | MEDICAID | 92726 | MEDICARE PTAN |
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