Individual
ELLEN RHEA WARREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
630 PASEO DEL PUEBLO SUR, SUITE 150, TAOS, NM 87571-6070
(575) 758-3005
(575) 758-7010
Mailing address
630 PASEO DEL PUEBLO SUR, SUITE 150, TAOS, NM 87571-6070
(575) 758-3005
(575) 758-7010
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
82-332
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080098206
RAILROAD MEDICARE
—
05
—
09167
—
NM
Enumeration date
05/01/2006
Last updated
09/22/2014
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