Healthcare Provider Details

I. General information

NPI: 1063882058
Provider Name (Legal Business Name): NOR LEA GENERAL HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/02/2015
Last Update Date: 10/02/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 N MAIN AVE
LOVINGTON NM
88260-2830
US

IV. Provider business mailing address

1125 W BRITTANY DR
HOBBS NM
88242-9706
US

V. Phone/Fax

Practice location:
  • Phone: 575-396-5059
  • Fax:
Mailing address:
  • Phone: 575-396-5059
  • Fax: 575-396-1454

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NR1301X
TaxonomyRural Acute Care Hospital
License NumberCNP-02768
License Number StateNM

VIII. Authorized Official

Name: MRS. KELLI ELIZABETH MCCALL
Title or Position: FNP/NURSE PRACTITIONER
Credential: FNP
Phone: 575-631-2336