Healthcare Provider Details

I. General information

NPI: 1124642772
Provider Name (Legal Business Name): LITTLE STEPS PEDIATRICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

1990 E LOHMAN AVE STE A
LAS CRUCES NM
88001-3117
US

IV. Provider business mailing address

PO BOX 13668
LAS CRUCES NM
88013-3668
US

V. Phone/Fax

Practice location:
  • Phone: 575-652-4580
  • Fax:
Mailing address:
  • Phone: 575-652-4580
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MEGHAN ROBINSON
Title or Position: PRESIDENT
Credential:
Phone: 575-652-4580