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General NPI Number Information
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NPI Number | 1114518412
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Entity Type | Individual
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Provider Name | DINA ELENA VALLE PHARM.D, RPH
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Gender | Female
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Dates
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Enumeration Date | 01/29/2021
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Last Update Date | 01/29/2021
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Provider Practice Location Address
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Address Line | 1256 EL PASEO RD
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City | LAS CRUCES
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State | NM
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Zip | 88001-6026
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Country | US
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Telephone | 575-525-8713
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Fax |
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Provider Business Mailing Address
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Address Line | 4100 SAN YSIDRO RD
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City | LAS CRUCES
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State | NM
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Zip | 88007-5414
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Country | US
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Telephone | 385-401-9912
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Fax |
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RP00009437
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License Number State | NM
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