Shanta, Loretta R
Shanta, Loretta R is an individual health care provider with primary practice located at 249 White Mountain Dr. , Mescalero NM 88340. She recently has only one registered license in Other Service Providers / Case Manager/Care Coordinator, which is considered as her primary health care specialty. Shanta, Loretta R can be contacted via phone (575) 630-0571.Contact Information
Primary practice address
249 White Mountain Dr.
Mescalero NM 88340
Phone: (575) 630-0571
Fax: (575) 630-0574
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Case Manager/Care Coordinator | 171M00000X |
Profile Details
| NPI number | 1750631958 |
|---|---|
| LBN Legal business name | Shanta, Loretta R |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2012 |
| Last updated | Mar 29th, 2014 - about 10 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 | 1750631958 | NPPES |
| New Mexico | MEDICAID | 18677037 |
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