Individual
DEBRA ANNE CARLISLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, MS
Contact information
Practice address
200 HOSPITAL DR, RATON, NM 87740-2013
(505) 445-7726
(505) 445-7708
Mailing address
31191 HWY 64, PO BOX 495, CIMARRON, NM 87714
(505) 376-2333
(505) 445-7708
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD 0657
NM
Other
Enumeration date
04/24/2007
Last updated
07/08/2007
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