Healthcare Provider Details

I. General information

NPI: 1487143509
Provider Name (Legal Business Name): LORA ANN MILLER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2018
Last Update Date: 03/29/2026
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 W BROADWAY ST
HOBBS NM
88240-5529
US

IV. Provider business mailing address

PO BOX 907
HOBBS NM
88241-0907
US

V. Phone/Fax

Practice location:
  • Phone: 575-393-3168
  • Fax: 575-397-4659
Mailing address:
  • Phone: 575-393-3168
  • Fax: 575-397-4659

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0001166770
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: