Provider Demographics
NPI:1639500085
Name:RAMOS, MIKHAILE (CNP)
Entity Type:Individual
Prefix:
First Name:MIKHAILE
Middle Name:
Last Name:RAMOS
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7033 KALGAN RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-3528
Mailing Address - Country:US
Mailing Address - Phone:505-800-8344
Mailing Address - Fax:818-363-3099
Practice Address - Street 1:184 UNSER BLVD NE STE B
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-4045
Practice Address - Country:US
Practice Address - Phone:505-896-0928
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-11
Last Update Date:2022-09-28
Deactivation Date:2022-05-13
Deactivation Code:
Reactivation Date:2022-09-01
Provider Licenses
StateLicense IDTaxonomies
NM68664363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily