Healthcare Provider Details

I. General information

NPI: 1881479343
Provider Name (Legal Business Name): TRESTLE MEDICAL SERVICES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2023
Last Update Date: 10/05/2023
Certification Date: 10/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 JAMES CANYON HIGHWAY
CLOUDCROFT NM
88317
US

IV. Provider business mailing address

60 ASSEMBLY CIRCLE
SACRAMENTO NM
88347
US

V. Phone/Fax

Practice location:
  • Phone: 806-324-7996
  • Fax:
Mailing address:
  • Phone: 806-324-7996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MRS. JULIA VICTORIA MALAVE EIGENMANN
Title or Position: OWNER
Credential: FNP-C
Phone: 806-324-7996