| NPI | 1629314844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORETTA MARGARET SPARKMAN Secretary 575-725-5562 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner Psychiatric/Mental Health |
| Enumeration Date | 2012-12-15 |
| Last Update Date | 2012-12-15 |