| Full Circle Healing Family Practice, Llc | |
|
2019 Galisteo St Ste N9a Santa Fe NM 87505-2111 | |
| (505) 820-1482 | |
| (505) 982-0696 |
| Full Name | Full Circle Healing Family Practice, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 2019 Galisteo St Ste N9a, Santa Fe, New Mexico |
| Authorized Official Name and Position | Heather Neil (MEMBER) |
| Authorized Official Contact | 5058201482 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Full Circle Healing Family Practice, Llc 2019 Galisteo St Ste N9a Santa Fe NM 87505-2111 Ph: (505) 820-1482 | Full Circle Healing Family Practice, Llc 2019 Galisteo St Ste N9a Santa Fe NM 87505-2111 Ph: (505) 820-1482 |
| NPI Number | 1134230287 |
|---|---|
| Provider Enumeration Date | 08/31/2006 |
| Last Update Date | 01/30/2024 |
| Medicare PECOS PAC ID | 7618913435 |
|---|---|
| Medicare Enrollment ID | O20050701000604 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134230287 | NPI | - | NPPES |
| 03728021 | Medicaid | NM |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 94-92 (New Mexico) | Primary |
| Provider Name | Janeen D Maas |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174534044 PECOS PAC ID: 6507755444 Enrollment ID: I20040310001563 |
| Provider Name | Debra K Higginbotham |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861460446 PECOS PAC ID: 5496843336 Enrollment ID: I20071110000161 |
| Provider Name | Sze Kim Pang |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1669597076 PECOS PAC ID: 1951444652 Enrollment ID: I20140814000943 |
| Provider Name | Amy P Adler |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1487678181 PECOS PAC ID: 7012961352 Enrollment ID: I20200617000152 |
| Provider Name | Michele Jasmin Sanders |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1225681570 PECOS PAC ID: 2062832769 Enrollment ID: I20201019002819 |
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