Healthcare Provider Details

I. General information

NPI: 1356224216
Provider Name (Legal Business Name): JOSHUA DAVID TAFOYA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 NM-187
HATCH NM
87937
US

IV. Provider business mailing address

PO BOX 370
HATCH NM
87937-0370
US

V. Phone/Fax

Practice location:
  • Phone: 575-267-3088
  • Fax: 575-267-3088
Mailing address:
  • Phone: 575-267-3088
  • Fax: 575-267-1747

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number58930
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: