Healthcare Provider Details

I. General information

NPI: 1023823697
Provider Name (Legal Business Name): ELIZABETH BITTNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/11/2025
Last Update Date: 02/11/2025
Certification Date: 02/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N ALAMEDA BLVD STE 1
LAS CRUCES NM
88005-2291
US

IV. Provider business mailing address

920 N ALAMEDA BLVD STE 1
LAS CRUCES NM
88005-2291
US

V. Phone/Fax

Practice location:
  • Phone: 915-319-3734
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: