Individual
IRIS REANO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
108 LONE MOUNTAIN ST, KEWA, NM 87052-9603
(505) 274-4003
Mailing address
108 LONE MOUNTAIN ST, KEWA, NM 87052-9603
(505) 274-4003
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
G-086
NM
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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