Provider Demographics
NPI:1043472244
Name:VERMILLION, JUNE (RN)
Entity Type:Individual
Prefix:MRS
First Name:JUNE
Middle Name:
Last Name:VERMILLION
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6519 KAAS TRAIL CT NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-7114
Mailing Address - Country:US
Mailing Address - Phone:505-856-9606
Mailing Address - Fax:
Practice Address - Street 1:525 BUENA VISTA DR SE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-4023
Practice Address - Country:US
Practice Address - Phone:505-224-4127
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-28
Last Update Date:2008-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR16382163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse