Healthcare Provider Details

I. General information

NPI: 1003352246
Provider Name (Legal Business Name): BIANCA ELENA MONTES FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2017
Last Update Date: 09/19/2025
Certification Date: 09/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1455 S VALLEY DR STE B
LAS CRUCES NM
88005-3165
US

IV. Provider business mailing address

579 CALLE DEL VALLE
LAS CRUCES NM
88007-7306
US

V. Phone/Fax

Practice location:
  • Phone: 575-526-6992
  • Fax: 575-526-7983
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number69314
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP132883
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: