Individual
JULIE SCHAEFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2300 E 30TH ST, BLDG B, SUITE 102, FARMINGTON, NM 87401-8990
(505) 324-1000
(505) 324-1199
Mailing address
2114 W APACHE ST, #A, FARMINGTON, NM 87401-3279
(505) 325-9683
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
#99-PA25
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
77719
—
NM
01
—
NM003000
BLUE CROSS
NM
01
—
PROVP16197
CIMMARON SALUD
NM
Enumeration date
07/24/2006
Last updated
01/22/2008
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