Holstead, Bobby N
Holstead, Bobby N is an individual health care provider with primary practice located at 2050A 2Nd St Se , Kirtland Afb NM 87117-5103. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Psychologist, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Psychologist is his primary health care specialty. Holstead, Bobby N can be contacted via phone (505) 846-3200.Contact Information
Primary practice address
2050A 2Nd St Se
Kirtland Afb NM 87117-5103
Phone: (505) 846-3200
Fax: (575) 784-6028
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | 214 | New Mexico |
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 214 | New Mexico |
Profile Details
| NPI number | 1487735965 |
|---|---|
| LBN Legal business name | Holstead, Bobby N |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 18th, 2006 |
| Last updated | Apr 2nd, 2021 - about 5 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 | 1487735965 | NPPES |
| New Mexico | Other | 00NM00N890 | BC/BS OF NM |
| New Mexico | MEDICAID | N6176 | BC/BS OF NM |
| New Mexico | Other | 201004465 | BC/BS OF NM |
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