| NPI | 1265686778 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONA JOHNSON Director Of Personel 575-762-4455 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM R33747) |
| Enumeration Date | 2008-11-11 |
| Last Update Date | 2008-11-11 |