Healthcare Provider Details

I. General information

NPI: 1104711670
Provider Name (Legal Business Name): CHRISTOPHER NUNEZ FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2025
Last Update Date: 01/08/2026
Certification Date: 01/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 W COUNTRY CLUB RD
ROSWELL NM
88201-5209
US

IV. Provider business mailing address

405 W COUNTRY CLUB RD
ROSWELL NM
88201-5209
US

V. Phone/Fax

Practice location:
  • Phone: 575-622-8170
  • Fax:
Mailing address:
  • Phone: 575-624-4663
  • Fax: 575-624-4907

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-90493
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number84538
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: