NPI 1609199447 · live from the CMS NPI Registry
Family Practice Medical And Dietetic Medical Therapy
Nurse Practitioner, Primary Care in Las Cruces, NM. National Provider Identifier 1609199447, active.
NPI record
| NPI | 1609199447 Type 2 · organization |
|---|---|
| Status | Active |
| Primary specialty | Nurse Practitioner, Primary Care 363LP2300X |
| Practice location | 2904 Hillrise Dr, Las Cruces, NM 88011 |
| Practice phone | 575-532-5386 |
| Enumerated | March 8, 2010 |
| Last updated | March 29, 2013 |
| Authorized official | Jose Rosales, Owner |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dietitian, Registered | 133V00000X | DT06119 (TX) |
| Dietitian, Registered | 133V00000X | LD0748 (NM) |
| Nurse Practitioner, Primary Care primary | 363LP2300X | CNP00942 (NM) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.