Healthcare Provider Details

I. General information

NPI: 1932106994
Provider Name (Legal Business Name): RICHARD HENRY LEVITT FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2005
Last Update Date: 04/06/2026
Certification Date: 04/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 W 21ST ST
CLOVIS NM
88101-4086
US

IV. Provider business mailing address

203 W CLEVELAND AVE
MORTON TX
79346-4049
US

V. Phone/Fax

Practice location:
  • Phone: 575-935-7777
  • Fax: 575-935-7778
Mailing address:
  • Phone: 806-891-5622
  • Fax: 575-205-0377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCMP00518
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP110471
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: