Healthcare Provider Details

I. General information

NPI: 1194652594
Provider Name (Legal Business Name): ANDREA HERRERA HIS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2026
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2001 E LOHMAN AVE STE 112
LAS CRUCES NM
88001-3198
US

IV. Provider business mailing address

2001 E LOHMAN AVE STE 112
LAS CRUCES NM
88001-3198
US

V. Phone/Fax

Practice location:
  • Phone: 575-232-9022
  • Fax: 575-288-2701
Mailing address:
  • Phone: 575-232-9022
  • Fax: 575-288-2701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberSAH-2026-0110
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: