| Rio Grande Family Medicine | |
|
711 Encino Pl Ne Ste D Albuquerque NM 87102-2650 | |
| (505) 224-7400 | |
| (505) 224-7404 |
| Full Name | Rio Grande Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 711 Encino Pl Ne Ste D, Albuquerque, New Mexico |
| Authorized Official Name and Position | Leslie Beth Corbin (OWNER) |
| Authorized Official Contact | 5052247400 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rio Grande Family Medicine 711 Encino Pl Ne Ste D Albuquerque NM 87102-2650 Ph: (505) 224-7400 | Rio Grande Family Medicine 711 Encino Pl Ne Ste D Albuquerque NM 87102-2650 Ph: (505) 224-7400 |
| NPI Number | 1164646600 |
|---|---|
| Provider Enumeration Date | 04/13/2007 |
| Last Update Date | 07/11/2023 |
| Medicare PECOS PAC ID | 0941480586 |
|---|---|
| Medicare Enrollment ID | O20110214000790 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164646600 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 02109459004 (New Mexico) | Primary |
| Provider Name | Satkirin K Khalsa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1144204496 PECOS PAC ID: 3173616596 Enrollment ID: I20070830000493 |
| Provider Name | Candace Percifull |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689941817 PECOS PAC ID: 1759557127 Enrollment ID: I20130211000180 |
| Provider Name | Maya A Lessen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1861825671 PECOS PAC ID: 7416182423 Enrollment ID: I20131029001442 |
| Provider Name | Dawn Michelle Geer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1689014136 PECOS PAC ID: 7113161241 Enrollment ID: I20191119001537 |
| Provider Name | Amy Jane Lozoya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1508410689 PECOS PAC ID: 5092137976 Enrollment ID: I20200623000927 |
| Provider Name | Shauna Lynn Montoya |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1386354512 PECOS PAC ID: 7214300870 Enrollment ID: I20230301000985 |
| Provider Name | Krystel Danette Habish |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427735836 PECOS PAC ID: 7719348531 Enrollment ID: I20230726002597 |
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