Healthcare Provider Details

I. General information

NPI: 1740075381
Provider Name (Legal Business Name): LAS CRUCES PERSONAL INJURY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 04/14/2025
Certification Date: 04/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2170 E LOHMAN AVE STE A
LAS CRUCES NM
88001-8411
US

IV. Provider business mailing address

2170 E LOHMAN AVE STE A
LAS CRUCES NM
88001-8411
US

V. Phone/Fax

Practice location:
  • Phone: 575-449-7002
  • Fax:
Mailing address:
  • Phone: 575-449-7002
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0000X
TaxonomyPain Management Registered Nurse
License Number
License Number State

VIII. Authorized Official

Name: MS. BROOKE ELIZABETH BAISAS
Title or Position: PRACTICE MANAGER
Credential:
Phone: 817-360-4881