Healthcare Provider Details

I. General information

NPI: 1356392989
Provider Name (Legal Business Name): KRISTEN GORBITZ CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2006
Last Update Date: 07/12/2022
Certification Date: 07/12/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2550 SAMARITAN DRIVE SUITE 241
LAS CRUCES NM
88001
US

IV. Provider business mailing address

4351 E LOHMAN AVE STE 408
LAS CRUCES NM
88011-8263
US

V. Phone/Fax

Practice location:
  • Phone: 575-386-5778
  • Fax: 575-680-2812
Mailing address:
  • Phone: 575-532-7161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberR34862
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: