Healthcare Provider Details

I. General information

NPI: 1245179670
Provider Name (Legal Business Name): CRYSTAL LYNN RHOADES FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/28/2026
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

612 N 13TH ST STE B
ARTESIA NM
88210-1110
US

IV. Provider business mailing address

1507 S 21ST ST
ARTESIA NM
88210-2511
US

V. Phone/Fax

Practice location:
  • Phone: 575-736-8394
  • Fax: 575-736-8468
Mailing address:
  • Phone: 210-850-8526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number88804
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number88804
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: