Healthcare Provider Details

I. General information

NPI: 1164111373
Provider Name (Legal Business Name): REYNALYNN SOEFKER PALANCA FNP-C; WHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2023
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18511 HIGHLANDER MEDICS ST
FORT BLISS TX
79906-5327
US

IV. Provider business mailing address

18511 HIGHLANDER MEDICS ST
FORT BLISS TX
79906-5327
US

V. Phone/Fax

Practice location:
  • Phone: 915-742-7777
  • Fax:
Mailing address:
  • Phone: 915-742-7777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171000000X
TaxonomyMilitary Health Care Provider
License Number89070
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number89070
License Number StateNM
# 3
Primary TaxonomyN
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number89070
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: