Rose, Nettie Lynne
Rose, Nettie Lynne is an sole proprietor health care provider with primary practice located at 1610 San Pedro Ne #A , Albuquerque NM 87110. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) is her primary health care specialty. Rose, Nettie Lynne can be contacted via phone (505) 265-0753.Contact Information
Primary practice address
1610 San Pedro Ne #A
Albuquerque NM 87110
Phone: (505) 265-0753
Fax: (505) 268-5722
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | 4198 | New Mexico |
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | I4453 | New Mexico |
| Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) | 101YA0400X | C-4453 | New Mexico |
Profile Details
| NPI number | 1407847403 |
|---|---|
| LBN Legal business name | Rose, Nettie Lynne |
| Credentials | LISW LADAC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Sep 9th, 2020 - about 4 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 | 1407847403 | NPPES |
| New Mexico | MEDICAID | 37376764 |
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