MEDICARE: CHANGES MENTAL HEALTH SERVICES PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1174750160
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	CHANGES MENTAL HEALTH SERVICES PLLC

Provider Business Mailing Address
First Line	:	1831 MARLYS LARSON ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-5098
Country	:	US
Telephone Number	:	915-857-1052
Fax Number	:

Provider Business Practice Location Address
First Line	:	1831 MARLYS LARSON ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79936-5098
Country	:	US
Telephone Number	:	915-857-1052
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	LOYD CURKEET
Credential	:	PMHNP
Telephone Number	:	915-577-0111

Provider Enumeration Date	:	06/17/2009
Last Update Date	:	06/17/2009

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