| NPI | 1336542992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANE K CORNWELL Owner 575-302-6683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: NM CNP01235) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2014-09-26 |
| Last Update Date | 2020-09-09 |