| Vessel Health Llc | |
|
7920 Wyoming Blvd Ne Suite B Albuquerque NM 87109-6020 | |
| (505) 828-3000 | |
| (505) 828-3002 |
| Full Name | Vessel Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 7920 Wyoming Blvd Ne, Albuquerque, New Mexico |
| Authorized Official Name and Position | Harvey White (OWNER) |
| Authorized Official Contact | 5058283000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vessel Health Llc 7920 Wyoming Blvd. Ne Suite B Albuquerque NM 87109-6021 Ph: (505) 828-3000 | Vessel Health Llc 7920 Wyoming Blvd Ne Suite B Albuquerque NM 87109-6020 Ph: (505) 828-3000 |
| NPI Number | 1508191206 |
|---|---|
| Provider Enumeration Date | 10/14/2009 |
| Last Update Date | 10/14/2009 |
| Medicare PECOS PAC ID | 9638218803 |
|---|---|
| Medicare Enrollment ID | O20091201000201 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508191206 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 89-133 (New Mexico) | Primary |
| Provider Name | Harvey J White |
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) |
| Provider Identifiers | NPI Number: 1790789592 PECOS PAC ID: 7517031065 Enrollment ID: I20080801000299 |
| Provider Name | Theresa A Gutierrez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1528491966 PECOS PAC ID: 9335378801 Enrollment ID: I20140203000315 |
| Provider Name | Allison K Mills |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699292920 PECOS PAC ID: 1052686839 Enrollment ID: I20171004001194 |
| Provider Name | Kristyn B Cordova |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1891289229 PECOS PAC ID: 2860740149 Enrollment ID: I20180802001225 |
| Provider Name | Jennifer L Castro |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1831753508 PECOS PAC ID: 5597194357 Enrollment ID: I20200331001642 |
| Provider Name | Lynn Shin |
|---|---|
| Provider Type | Practitioner - Vascular Surgery |
| Provider Identifiers | NPI Number: 1346341591 PECOS PAC ID: 9638134034 Enrollment ID: I20201113000582 |
| Provider Name | Ashley Nicole Champlin |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1407449838 PECOS PAC ID: 3779990668 Enrollment ID: I20210319001263 |
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