Provider Demographics
NPI:1134487952
Name:MEDICAL MANAGEMENT INC
Entity Type:Organization
Organization Name:MEDICAL MANAGEMENT INC
Other - Org Name:REEVE MEDICAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JACQUELYN
Authorized Official - Middle Name:P
Authorized Official - Last Name:REEVE
Authorized Official - Suffix:
Authorized Official - Credentials:CNP
Authorized Official - Phone:505-924-4444
Mailing Address - Street 1:10400 ACADEMY RD NE
Mailing Address - Street 2:SUITE 390
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87111-1229
Mailing Address - Country:US
Mailing Address - Phone:505-294-4444
Mailing Address - Fax:505-323-2222
Practice Address - Street 1:10400 ACADEMY RD NE
Practice Address - Street 2:SUITE 390
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87111-1229
Practice Address - Country:US
Practice Address - Phone:505-294-4444
Practice Address - Fax:505-323-2222
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-01687364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult HealthGroup - Single Specialty