Healthcare Provider Details

I. General information

NPI: 1376543009
Provider Name (Legal Business Name): DEBORAH SCHMIDT CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2005
Last Update Date: 08/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 CHAPARREL BLVD. NW
DEMING NM
88030
US

IV. Provider business mailing address

PO BOX 370
HATCH NM
87937-0370
US

V. Phone/Fax

Practice location:
  • Phone: 575-546-4800
  • Fax: 575-546-0685
Mailing address:
  • Phone: 575-267-3280
  • Fax: 575-267-1747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberCNP00135
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: