Provider Demographics
NPI:1982927752
Name:RODRIGUEZ WALTERS, ROMELIA (AE-C)
Entity type:Individual
Prefix:
First Name:ROMELIA
Middle Name:
Last Name:RODRIGUEZ WALTERS
Suffix:
Gender:F
Credentials:AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6401 ZIMMERMAN AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87110-5930
Mailing Address - Country:US
Mailing Address - Phone:505-274-4306
Mailing Address - Fax:505-205-1462
Practice Address - Street 1:6020 MADDUX PL NW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-4604
Practice Address - Country:US
Practice Address - Phone:505-259-6277
Practice Address - Fax:505-205-1462
Is Sole Proprietor?:No
Enumeration Date:2010-03-09
Last Update Date:2010-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator