Healthcare Provider Details

I. General information

NPI: 1336043314
Provider Name (Legal Business Name): ERYN NICOLE ACOSTA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

408 N CANYON ST
CARLSBAD NM
88220-5812
US

IV. Provider business mailing address

408 N CANYON ST
CARLSBAD NM
88220-5812
US

V. Phone/Fax

Practice location:
  • Phone: 575-234-3300
  • Fax:
Mailing address:
  • Phone: 575-234-3300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number68608
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: