Healthcare Provider Details

I. General information

NPI: 1518266576
Provider Name (Legal Business Name): BETH ELAINE RIECHES NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2011
Last Update Date: 07/25/2024
Certification Date: 07/25/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2748-B HWY 35N
MIMBRES NM
88049
US

IV. Provider business mailing address

530 DEMOSS ST.
LORDSBURG NM
88045
US

V. Phone/Fax

Practice location:
  • Phone: 575-536-3990
  • Fax: 575-536-3991
Mailing address:
  • Phone: 575-542-8384
  • Fax: 575-313-8235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024184369
License Number StateVA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number209.007918
License Number StateIL
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71015294A
License Number StateIN
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number71465
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: