Elemental Health And Wellness Center Llc | |
4425 Juan Tabo Blvd Ne Ste 112 Albuquerque NM 87111-2684 | |
(505) 503-6800 | |
Not Available |
Full Name | Elemental Health And Wellness Center Llc |
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Speciality | Marriage & Family Therapist |
Location | 4425 Juan Tabo Blvd Ne Ste 112, Albuquerque, New Mexico |
Authorized Official Name and Position | Anne Cannon (OWNER) |
Authorized Official Contact | 5055036800 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Elemental Health And Wellness Center Llc 4425 Juan Tabo Blvd Ne Ste 112 Albuquerque NM 87111-2684 Ph: (505) 503-6800 | Elemental Health And Wellness Center Llc 4425 Juan Tabo Blvd Ne Ste 112 Albuquerque NM 87111-2684 Ph: (505) 503-6800 |
NPI Number | 1891125183 |
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Provider Enumeration Date | 11/22/2013 |
Last Update Date | 10/13/2023 |
Certification Date | 10/13/2023 |
Medicare PECOS PAC ID | 0446481881 |
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Medicare Enrollment ID | O20140327000787 |
Identifier | Type | State | Issuer |
---|---|---|---|
1891125183 | NPI | - | NPPES |
Provider Name | Patricia L Bryant |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1114961786 PECOS PAC ID: 3577558469 Enrollment ID: I20040419001590 |
Provider Name | Letha S Olmos |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1215129143 PECOS PAC ID: 1052440302 Enrollment ID: I20100525000124 |
Provider Name | Teresann Nickle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1831245786 PECOS PAC ID: 8426130774 Enrollment ID: I20110408000378 |
Provider Name | Jayanna Warwick |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437407301 PECOS PAC ID: 0143479626 Enrollment ID: I20120926000551 |
Provider Name | Aloysius David Nawrocki |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1730141557 PECOS PAC ID: 4789833070 Enrollment ID: I20121002000149 |
Provider Name | Anthony James Holzgang |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1073598298 PECOS PAC ID: 6103014774 Enrollment ID: I20131008000283 |
Provider Name | Melissa Rose Moore |
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Provider Type | Practitioner - Certified Nurse Midwife (cnm) |
Provider Identifiers | NPI Number: 1619392172 PECOS PAC ID: 4385868629 Enrollment ID: I20140606001479 |
Provider Name | Laureli M Scribner |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1174572820 PECOS PAC ID: 9931092194 Enrollment ID: I20150218002129 |
Provider Name | Alicia Burbano |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1083857247 PECOS PAC ID: 2769609791 Enrollment ID: I20160810000795 |
Provider Name | Milena Sudak |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1164764304 PECOS PAC ID: 7911272372 Enrollment ID: I20171011000667 |
Provider Name | Paula S Eastman |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1790183549 PECOS PAC ID: 2961834403 Enrollment ID: I20191121000796 |
Provider Name | Brenda Medina |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1023490034 PECOS PAC ID: 2860827409 Enrollment ID: I20200109000027 |
Provider Name | David O Asante |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1891326138 PECOS PAC ID: 0840627162 Enrollment ID: I20200227000132 |
Provider Name | Stephen J Oravec |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1013523604 PECOS PAC ID: 9537572052 Enrollment ID: I20201230000946 |
Provider Name | Karen L Jones |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1851818157 PECOS PAC ID: 0840688891 Enrollment ID: I20211026000009 |
Provider Name | James Hogle |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1760710164 PECOS PAC ID: 3779734884 Enrollment ID: I20211209002579 |
Provider Name | Sarah K Alsgaard |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1285154104 PECOS PAC ID: 4385918143 Enrollment ID: I20211215000142 |
Provider Name | Tasha Hill |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1356060305 PECOS PAC ID: 2466828686 Enrollment ID: I20221013000235 |
Provider Name | Sandra Gayle Salazar |
---|---|
Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1104608322 PECOS PAC ID: 3577916592 Enrollment ID: I20240125004296 |
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