Provider Demographics
NPI:1508616996
Name:LAMERY, ANNIKAH MAE (RN)
Entity Type:Individual
Prefix:
First Name:ANNIKAH
Middle Name:MAE
Last Name:LAMERY
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 1:505 W 30TH ST
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-3927
Mailing Address - Country:US
Mailing Address - Phone:360-742-6412
Mailing Address - Fax:
Practice Address - Street 1:901 MCCOY AVE
Practice Address - Street 2:
Practice Address - City:AZTEC
Practice Address - State:NM
Practice Address - Zip Code:87410-1727
Practice Address - Country:US
Practice Address - Phone:505-334-6831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM59508163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse