Healthcare Provider Details

I. General information

NPI: 1144677493
Provider Name (Legal Business Name): JEAN HUFZIGER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2016
Last Update Date: 05/23/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4450 N VALLEY DR
LAS CRUCES NM
88007-5446
US

IV. Provider business mailing address

505 S MAIN ST STE 249
LAS CRUCES NM
88001-1243
US

V. Phone/Fax

Practice location:
  • Phone: 575-527-9516
  • Fax: 575-527-9717
Mailing address:
  • Phone: 575-527-5884
  • Fax: 575-527-5886

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN-69290
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: