Individual
JANET FACKRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4100 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 702-8547
Mailing address
4100 BARBARA LOOP SE, RIO RANCHO, NM 87124-1000
(505) 702-8547
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
1235
NM
Other
Enumeration date
12/27/2021
Last updated
12/27/2021
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