Healthcare Provider Details

I. General information

NPI: 1235444530
Provider Name (Legal Business Name): JOYCE MESERVE PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 08/11/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3695 HOT SPRINGS BLVD
LAS VEGAS NM
87701-9549
US

IV. Provider business mailing address

3695 HOT SPRINGS BLVD
LAS VEGAS NM
87701-9549
US

V. Phone/Fax

Practice location:
  • Phone: 505-454-2348
  • Fax: 505-454-2329
Mailing address:
  • Phone: 505-454-2348
  • Fax: 505-454-2329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP-01651
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: