Healthcare Provider Details

I. General information

NPI: 1669240032
Provider Name (Legal Business Name): DANIEL YEE
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/15/2023
Last Update Date: 12/15/2023
Certification Date: 12/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 S MAIN ST STE 249
LAS CRUCES NM
88001-1243
US

IV. Provider business mailing address

4760 BIG SPRINGS ST
LAS CRUCES NM
88012-7509
US

V. Phone/Fax

Practice location:
  • Phone: 575-527-5823
  • Fax: 575-527-5886
Mailing address:
  • Phone: 575-520-5058
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number56598
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: