Healthcare Provider Details

I. General information

NPI: 1932877446
Provider Name (Legal Business Name): RUBY MARISELA BARQUIST CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RUBY MARISELA HERNANDEZ

II. Dates (important events)

Enumeration Date: 08/31/2021
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 COMMERCE DR
LAS CRUCES NM
88011-8209
US

IV. Provider business mailing address

1130 COMMERCE DR
LAS CRUCES NM
88011-8209
US

V. Phone/Fax

Practice location:
  • Phone: 575-405-4062
  • Fax: 888-592-0422
Mailing address:
  • Phone: 575-405-4062
  • Fax: 888-592-0422

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number85019
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: