Healthcare Provider Details

I. General information

NPI: 1003676362
Provider Name (Legal Business Name): RHAEMI E GAUFIN DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2024
Last Update Date: 03/21/2024
Certification Date: 03/21/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3961 E LOHMAN AVE STE 33
LAS CRUCES NM
88011-8440
US

IV. Provider business mailing address

3922 AGUA DE VIDA DR
LAS CRUCES NM
88012-7962
US

V. Phone/Fax

Practice location:
  • Phone: 575-556-0200
  • Fax:
Mailing address:
  • Phone: 575-308-6284
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number53100
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: