Individual ProviderNathaniel SierraCase Manager/Care CoordinatorOther Service ProvidersPractice Address4118 Central Ave SE, Albuquerque, NM 87108-1177(505) 239-8136(505) 463-1970PECOS EnrollmentBased on the most recent information from CMS, provider Nathaniel Sierra does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 12:57 PM.Profile DetailsProvider ID1801444658Provider TypeIndividualFull NameSierra, NathanielGenderMaleSole ProprietorNoEnumeration Date8/26/2019Last Updated8/26/2019Contact InformationPractice LocationPractice Address4118 Central Ave SE, Albuquerque, NM 87108-1177Phone(505) 239-8136FaxUnlisted FaxMailing LocationMailing AddressPO Box 35104, Albuquerque, NM 87176-5104Phone(505) 463-1970FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer