Provider Demographics
NPI:1790105666
Name:BRIONES, ERMA
Entity Type:Individual
Prefix:
First Name:ERMA
Middle Name:
Last Name:BRIONES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:ARTESIA
Mailing Address - State:NM
Mailing Address - Zip Code:88210-1125
Mailing Address - Country:US
Mailing Address - Phone:575-746-9819
Mailing Address - Fax:
Practice Address - Street 1:1001 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:ARTESIA
Practice Address - State:NM
Practice Address - Zip Code:88210-1125
Practice Address - Country:US
Practice Address - Phone:575-756-9819
Practice Address - Fax:575-748-9755
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-18
Last Update Date:2014-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMB-04927171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator