Healthcare Provider Details

I. General information

NPI: 1649330325
Provider Name (Legal Business Name): BESTCARE FAMILY MEDICAL SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2701 W PICACHO AVE SUITE 8
LAS CRUCES NM
88007-4775
US

IV. Provider business mailing address

2701 W PICACHO AVE SUITE 8
LAS CRUCES NM
88007-4775
US

V. Phone/Fax

Practice location:
  • Phone: 505-527-2300
  • Fax: 505-527-2302
Mailing address:
  • Phone: 505-527-2300
  • Fax: 505-527-2302

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR37541
License Number StateNM

VIII. Authorized Official

Name: MICHAEL JEFFREY O'CONNELL
Title or Position: OWNER
Credential: FNP-C
Phone: 505-527-2300