Healthcare Provider Details

I. General information

NPI: 1548198203
Provider Name (Legal Business Name): AMBER REA GREEN-PRITCHETT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1096 MECHEM DR STE 302B
RUIDOSO NM
88345-7057
US

IV. Provider business mailing address

6688 N CENTRAL EXPY STE 1300
DALLAS TX
75206-3950
US

V. Phone/Fax

Practice location:
  • Phone: 575-315-0592
  • Fax: 575-258-2648
Mailing address:
  • Phone: 469-621-8696
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN-72021
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: