Healthcare Provider Details

I. General information

NPI: 1023780293
Provider Name (Legal Business Name): TONIA ELIZABETH MONTOYA FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2021
Last Update Date: 11/19/2025
Certification Date: 11/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 N MAIN ST
ROSWELL NM
88201-5010
US

IV. Provider business mailing address

302 N KANSAS AVE
ROSWELL NM
88201-3050
US

V. Phone/Fax

Practice location:
  • Phone: 575-627-4200
  • Fax:
Mailing address:
  • Phone: 575-637-2177
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number65234
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: