Healthcare Provider Details

I. General information

NPI: 1093678591
Provider Name (Legal Business Name): NICHOLAS ROBBINS CPSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2025
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 N ALAMEDA BLVD
LAS CRUCES NM
88005-2590
US

IV. Provider business mailing address

303 N ALAMEDA BLVD
LAS CRUCES NM
88005-2590
US

V. Phone/Fax

Practice location:
  • Phone: 575-523-0111
  • Fax: 575-323-3046
Mailing address:
  • Phone: 575-523-0111
  • Fax: 575-323-3046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number1985
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: