Individual
JAINEEN BURKETTSIMS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11005 SPAIN RD NE STE 22, ALBUQUERQUE, NM 87111-1871
(505) 250-8851
(505) 843-8449
Mailing address
11005 SPAIN RD NE STE 22, ALBUQUERQUE, NM 87111-1871
(505) 250-8851
(505) 843-8449
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36873594
—
NM
Enumeration date
10/15/2019
Last updated
10/15/2019
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