Healthcare Provider Details

I. General information

NPI: 1427790989
Provider Name (Legal Business Name): NEXT STEP PSYCHIATRY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2022
Last Update Date: 12/07/2022
Certification Date: 12/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2504 ASHFORD DR
CLOVIS NM
88101-4436
US

IV. Provider business mailing address

906 PEARSON DR
ROSWELL NM
88201-1168
US

V. Phone/Fax

Practice location:
  • Phone: 575-208-6118
  • Fax: 575-208-6753
Mailing address:
  • Phone: 575-935-6398
  • Fax: 575-935-6399

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SAMWEL RORYA
Title or Position: OWNER
Credential: PMHNP
Phone: 575-935-6398