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General NPI Number Information
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NPI Number | 1013430974
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Entity Type | Individual
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Provider Name | EKAETTE OGODO PMHNP
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Gender | Female
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Dates
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Enumeration Date | 07/24/2017
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | PO BOX 2608
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City | DEMING
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State | NM
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Zip | 88031-2608
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Country | US
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Telephone | 575-546-4800
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Fax | 575-546-0685
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Provider Business Mailing Address
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Address Line | 385 CALLE DE ALEGRA BLDG A
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City | LAS CRUCES
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State | NM
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Zip | 88005-3423
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Country | US
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Telephone | 575-526-1105
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Fax | 575-524-4266
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | CNP-03459
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | CNP-03459
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 9295515
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License Number State | FL
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