Healthcare Provider Details

I. General information

NPI: 1487181434
Provider Name (Legal Business Name): RICKI L ARMSTRONG FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2017
Last Update Date: 05/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 MAIN ST NW
LOS LUNAS NM
87031-4812
US

IV. Provider business mailing address

PO BOX 1454
PERALTA NM
87042-1454
US

V. Phone/Fax

Practice location:
  • Phone: 505-869-3478
  • Fax:
Mailing address:
  • Phone: 505-869-3478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP-03240
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: