Healthcare Provider Details

I. General information

NPI: 1679966451
Provider Name (Legal Business Name): LANEY PIERCE CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/18/2015
Last Update Date: 02/11/2026
Certification Date: 02/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 N DR MARTIN LUTHER KING JR BLVD
CLOVIS NM
88101-9401
US

IV. Provider business mailing address

PO BOX 1087
CLOVIS NM
88102-1087
US

V. Phone/Fax

Practice location:
  • Phone: 575-762-4455
  • Fax: 575-935-5455
Mailing address:
  • Phone: 575-762-4455
  • Fax: 575-935-5455

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP-02629
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: