Healthcare Provider Details

I. General information

NPI: 1629874037
Provider Name (Legal Business Name): ROBIN ATTERTON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBIN ATTERTON

II. Dates (important events)

Enumeration Date: 02/25/2025
Last Update Date: 02/26/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 COMMERCE WAY
CLOVIS NM
88101-4751
US

IV. Provider business mailing address

321 COMMERCE WAY
CLOVIS NM
88101-4750
US

V. Phone/Fax

Practice location:
  • Phone: 575-935-6262
  • Fax:
Mailing address:
  • Phone: 575-935-6262
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License NumberSEC-62-003973-2023
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225XM0800X
TaxonomyMental Health Occupational Therapist
License NumberSEC-62-003973-2023
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: