| Espanola Family Care | |
|
1302 E Calle Merced Espanola NM 87532 | |
| (505) 753-9292 | |
| Not Available |
| Full Name | Espanola Family Care |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 1302 E Calle Merced, Espanola, New Mexico |
| Authorized Official Name and Position | Michael Wiechart (CEO) |
| Authorized Official Contact | 6153726508 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Espanola Family Care 3917 West Rd Los Alamos NM 87544-2275 Ph: () - | Espanola Family Care 1302 E Calle Merced Espanola NM 87532 Ph: (505) 753-9292 |
| NPI Number | 1497878664 |
|---|---|
| Provider Enumeration Date | 04/10/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497878664 | NPI | - | NPPES |
| 79228313 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363L00000X | Nurse Practitioner | (* (Not Available)) | Primary |
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