Acantilado, Jeannine M
Acantilado, Jeannine M is an individual health care provider with primary practice located at 1100 Central Ave Se , Albuquerque NM 87106-4930. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Acantilado, Jeannine M can be contacted via phone (505) 841-1819.Contact Information
Primary practice address
1100 Central Ave Se
Albuquerque NM 87106-4930
Phone: (505) 841-1819
Fax: (505) 841-1998
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | R54517 | New Mexico |
Profile Details
| NPI number | 1477504959 |
|---|---|
| LBN Legal business name | Acantilado, Jeannine M |
| Credentials | Certified Nurse Practitioner (CNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 12th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1477504959 | NPPES |
| New Mexico | MEDICAID | PENDING |
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