Healthcare Provider Details

I. General information

NPI: 1508687468
Provider Name (Legal Business Name): PRIMARY CARE COMPLETE, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1685 MCNUTT RD STE 1
SUNLAND PARK NM
88063-9613
US

IV. Provider business mailing address

1685 MCNUTT RD STE 1
SUNLAND PARK NM
88063-9613
US

V. Phone/Fax

Practice location:
  • Phone: 575-332-4888
  • Fax:
Mailing address:
  • Phone: 575-332-4888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: MONICA ARELLANO
Title or Position: OWNER
Credential: FNP
Phone: 915-490-7996