Healthcare Provider Details

I. General information

NPI: 1164168225
Provider Name (Legal Business Name): KATRINA LYNN NAJERA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1313 N THORNTON ST
CLOVIS NM
88101-5549
US

IV. Provider business mailing address

1313 N THORNTON ST
CLOVIS NM
88101-5549
US

V. Phone/Fax

Practice location:
  • Phone: 575-265-8512
  • Fax:
Mailing address:
  • Phone: 575-265-8512
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code247200000X
TaxonomyOther Technician
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: