Healthcare Provider Details

I. General information

NPI: 1619584810
Provider Name (Legal Business Name): CHRISTINA M BAROS CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2020
Last Update Date: 05/26/2022
Certification Date: 05/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1202 HIGHWAY 60
SOCORRO NM
87801-3914
US

IV. Provider business mailing address

1202 HIGHWAY 60
SOCORRO NM
87801-3914
US

V. Phone/Fax

Practice location:
  • Phone: 575-835-8364
  • Fax:
Mailing address:
  • Phone: 575-835-8364
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number61652
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: