Provider Demographics
NPI:1598863342
Name:RAFTER, ANNIE (CNP, RN)
Entity type:Individual
Prefix:MS
First Name:ANNIE
Middle Name:
Last Name:RAFTER
Suffix:
Gender:F
Credentials:CNP, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1925 ROSINA ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:SANTA FE
Mailing Address - State:NM
Mailing Address - Zip Code:87505
Mailing Address - Country:US
Mailing Address - Phone:505-984-8262
Mailing Address - Fax:505-984-1312
Practice Address - Street 1:1925 ROSINA ST
Practice Address - Street 2:SUITE E
Practice Address - City:SANTA FE
Practice Address - State:NM
Practice Address - Zip Code:87505
Practice Address - Country:US
Practice Address - Phone:505-984-8262
Practice Address - Fax:505-984-1312
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR29765163WG0000X, 363LP2300X
NMCNP00587363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice