Healthcare Provider Details

I. General information

NPI: 1902437999
Provider Name (Legal Business Name): TANIA DANETTE BILLSTONE-SIMPSON MSN, APRN, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 05/10/2024
Certification Date: 05/10/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3870 FOOTHILLS RD
LAS CRUCES NM
88011-4631
US

IV. Provider business mailing address

5275 SINGER RD
LAS CRUCES NM
88007-5566
US

V. Phone/Fax

Practice location:
  • Phone: 575-800-0645
  • Fax:
Mailing address:
  • Phone: 575-915-4230
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number59015
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: