Provider Demographics
NPI:1700914975
Name:RAMIREZ, NINETTE LINDA (OTR)
Entity Type:Individual
Prefix:MS
First Name:NINETTE
Middle Name:LINDA
Last Name:RAMIREZ
Suffix:
Gender:F
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1400 CORRIZ DR SW
Mailing Address - Street 2:1400 CORRIZ RD. S.W.
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87121-8311
Mailing Address - Country:US
Mailing Address - Phone:505-836-0623
Mailing Address - Fax:505-836-7734
Practice Address - Street 1:1400 CORRIZ DR SW
Practice Address - Street 2:1400 CORRIZ S.W.
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87121-8311
Practice Address - Country:US
Practice Address - Phone:505-836-0623
Practice Address - Fax:505-836-7734
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-01
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1134225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM20984Medicaid