Provider Demographics
NPI:1073574372
Name:SCHOLDER, ROMONA DOROTHY (RN CS)
Entity Type:Individual
Prefix:MS
First Name:ROMONA
Middle Name:DOROTHY
Last Name:SCHOLDER
Suffix:
Gender:F
Credentials:RN CS
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Mailing Address - Street 1:125 E PALACE AVE
Mailing Address - Street 2:OFFICE #74
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87501
Mailing Address - Country:US
Mailing Address - Phone:505-982-5044
Mailing Address - Fax:505-466-0697
Practice Address - Street 1:125 E PALACE AVE
Practice Address - Street 2:OFFICE #74
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87501
Practice Address - Country:US
Practice Address - Phone:505-982-5044
Practice Address - Fax:505-466-0697
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-28
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NMR07512364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000N4146Medicaid
S50696Medicare UPIN