| Rocky Mountain Clinics Llc | |
|
313 N Locke Ave Farmington NM 87401-5854 | |
| (505) 787-2367 | |
| Not Available |
| Full Name | Rocky Mountain Clinics Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 313 N Locke Ave, Farmington, New Mexico |
| Authorized Official Name and Position | Sabrina Gibson (CFO) |
| Authorized Official Contact | 9704939193 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Rocky Mountain Clinics Llc 1120 E Elizabeth St Ste G2 Fort Collins CO 80524-4044 Ph: () - | Rocky Mountain Clinics Llc 313 N Locke Ave Farmington NM 87401-5854 Ph: (505) 787-2367 |
| NPI Number | 1285350066 |
|---|---|
| Provider Enumeration Date | 10/13/2022 |
| Last Update Date | 03/14/2023 |
| Medicare PECOS PAC ID | 5597136218 |
|---|---|
| Medicare Enrollment ID | O20230630001619 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1285350066 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207QA0401X | Family Medicine - Addiction Medicine | (* (Not Available)) | Primary |
| Provider Name | Tamaki Anne Harrold |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841629722 PECOS PAC ID: 3678797479 Enrollment ID: I20140618000747 |
| Provider Name | Melissa C Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972985331 PECOS PAC ID: 7719272301 Enrollment ID: I20160822001116 |
| Provider Name | Kathleen Crislip |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1568974160 PECOS PAC ID: 6204195217 Enrollment ID: I20180122000465 |
| Provider Name | Clark Mccoy |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871517912 PECOS PAC ID: 2567481005 Enrollment ID: I20201102001352 |
| Provider Name | Gail R Logue |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1013367507 PECOS PAC ID: 0840685699 Enrollment ID: I20220315001221 |
| Provider Name | Melissa C Miller |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972985331 PECOS PAC ID: 7719272301 Enrollment ID: I20230719000029 |
| Provider Name | Michelle Powell |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1417459108 PECOS PAC ID: 0749543791 Enrollment ID: I20231117001364 |
| Provider Name | Eleonora Trujillo |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972104115 PECOS PAC ID: 8426493180 Enrollment ID: I20240304003089 |
| Provider Name | Karissa Gayosso |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1841836699 PECOS PAC ID: 7113356973 Enrollment ID: I20240308001339 |
| Provider Name | Collin Zander |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1992086839 PECOS PAC ID: 8527398833 Enrollment ID: I20240326002127 |
| Provider Name | Stephen Carleton |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1508646373 PECOS PAC ID: 1254780919 Enrollment ID: I20240409004884 |
| Provider Name | Nathan Jipson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093463234 PECOS PAC ID: 0749630366 Enrollment ID: I20240425003848 |
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