Provider Demographics
NPI:1033835608
Name:COLIBRI HOUSE CALLS LLC
Entity Type:Organization
Organization Name:COLIBRI HOUSE CALLS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:KIMBERLY
Authorized Official - Middle Name:A
Authorized Official - Last Name:BOCAZ
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:505-290-9495
Mailing Address - Street 1:PO BOX 52045
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87181-2045
Mailing Address - Country:US
Mailing Address - Phone:505-290-9495
Mailing Address - Fax:866-770-4164
Practice Address - Street 1:744 SUPPER ROCK DR NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87123-2211
Practice Address - Country:US
Practice Address - Phone:505-290-9495
Practice Address - Fax:866-770-4164
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-17
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care