Healthcare Provider Details

I. General information

NPI: 1376114801
Provider Name (Legal Business Name): KELSEY GARCIA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2021
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 N JEFFERSON ST
HOBBS NM
88240-5332
US

IV. Provider business mailing address

1600 N MAIN AVE
LOVINGTON NM
88260-2813
US

V. Phone/Fax

Practice location:
  • Phone: 575-433-3030
  • Fax:
Mailing address:
  • Phone: 515-396-6611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1046806
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number64539
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: