Mallernee, Mary Leanora

Mallernee, Mary Leanora is an individual health care provider with primary practice located at Us Hwy 491 N , Shiprock NM 87420. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Mallernee, Mary Leanora can be contacted via phone (505) 368-6401.

Contact Information

Primary practice address
Us Hwy 491 N Shiprock NM 87420
Phone: (505) 368-6401
Fax: (505) 368-6431
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X R49684 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R49684 New Mexico

Profile Details

NPI number 1407846801
LBN Legal business name Mallernee, Mary Leanora
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Jan 16th, 2008 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407846801 NPPES
New Mexico MEDICAID 42979323
New Mexico MEDICAID 99777533
New Mexico MEDICAID 803735

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