| NPI | 1295313559 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRISH ANDREWS Administrator 575-910-2390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-03-30 |
| Last Update Date | 2025-04-28 |