Healthcare Provider Details
I. General information
NPI: 1801516489
Provider Name (Legal Business Name): NEXUS HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/01/2022
Last Update Date: 10/30/2024
Certification Date: 10/30/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
4200 BECKNER ROAD
SANTA FE NM
87507
US
IV. Provider business mailing address
4200 BECKNER ROAD
SANTA FE NM
87507
US
V. Phone/Fax
- Phone: 505-670-8292
- Fax:
- Phone: 505-670-8292
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QM1300X |
| Taxonomy | Multi-Specialty Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NICOLE
M
MCKINNEY
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 505-670-8292