Healthcare Provider Details

I. General information

NPI: 1891405643
Provider Name (Legal Business Name): BEE HEALTHY PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2022
Last Update Date: 12/02/2022
Certification Date: 12/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

780 S WALNUT ST
LAS CRUCES NM
88001-1425
US

IV. Provider business mailing address

780 S WALNUT ST
LAS CRUCES NM
88001-1425
US

V. Phone/Fax

Practice location:
  • Phone: 575-545-2697
  • Fax: 575-209-5003
Mailing address:
  • Phone: 575-545-2697
  • Fax: 575-209-5003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: CRISTIANNA GARCIA
Title or Position: OWNER
Credential: DNP
Phone: 575-545-2697