Healthcare Provider Details

I. General information

NPI: 1336006717
Provider Name (Legal Business Name): DEBORAH KAY JOHNSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2026
Last Update Date: 01/07/2026
Certification Date: 01/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N TELSHOR BLVD STE A
LAS CRUCES NM
88011-8279
US

IV. Provider business mailing address

920 N TELSHOR BLVD STE A
LAS CRUCES NM
88011-8279
US

V. Phone/Fax

Practice location:
  • Phone: 575-526-3277
  • Fax: 575-522-0026
Mailing address:
  • Phone: 575-526-3277
  • Fax: 575-522-0026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHAD0943
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: