1467454744 NPI number — DR. ROBIN NANCY HERMES MD

Table of content: MARK P HAGEN D.O. (NPI 1225358740)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467454744 NPI number — DR. ROBIN NANCY HERMES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERMES
Provider First Name:
ROBIN
Provider Middle Name:
NANCY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467454744
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 26666
Provider Second Line Business Mailing Address:
PROVIDER ENROLLMENT
Provider Business Mailing Address City Name:
ALBUQUERQUE
Provider Business Mailing Address State Name:
NM
Provider Business Mailing Address Postal Code:
87125-6666
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
505-923-6770
Provider Business Mailing Address Fax Number:
505-923-5354

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4200 BECKNER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SANTA FE
Provider Business Practice Location Address State Name:
NM
Provider Business Practice Location Address Postal Code:
87507-3774
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
505-477-2200
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/01/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207LP2900X , with the licence number:  98-289 , registered in the state of NM ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 05359082 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".
  • Identifier: NM009C66 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NM ) . This identifiers is of the category "OTHER".
  • Identifier: 28298 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".
  • Identifier: 439431 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: T8267 , issued by the state of ( NM ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2026 www.npivalidator.com