Healthcare Provider Details

I. General information

NPI: 1437482940
Provider Name (Legal Business Name): JANETTE BEATRIZ ESPINOZA PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/15/2009
Last Update Date: 09/15/2009
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: 505-454-2201
  • Fax: 505-454-2211
Mailing address:
  • Phone: 505-454-2201
  • Fax: 505-454-2211

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberCNP-01530
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: