Healthcare Provider Details

I. General information

NPI: 1841126760
Provider Name (Legal Business Name): MRS. EMILY MAE MACKEY LITTAUER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2026
Last Update Date: 06/18/2026
Certification Date: 06/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 ENTERPRISE RD
SOCORRO NM
87801-4199
US

IV. Provider business mailing address

4000 AVENTINE DR APT 204
ARDEN NC
28704-0345
US

V. Phone/Fax

Practice location:
  • Phone: 575-835-4444
  • Fax:
Mailing address:
  • Phone: 518-428-2186
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number90131
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: