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General NPI Number Information
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NPI Number | 1134499262
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Entity Type | Organization
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Legal Business Name | ROSWELL FAMILY CARE, LLC
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Dates
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Enumeration Date | 01/05/2012
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Last Update Date | 01/26/2016
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Provider Practice Location Address
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Address Line | 614 N MAIN ST
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City | ROSWELL
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State | NM
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Zip | 88201-4824
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Country | US
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Telephone | 719-203-5023
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Fax | 719-503-5024
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Provider Business Mailing Address
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Address Line | 614 N MAIN ST
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City | ROSWELL
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State | NM
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Zip | 88201-4824
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Country | US
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Telephone | 719-203-5023
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Fax | 719-503-5024
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. ELIZABETH SCHEAR
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Credential |
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Telephone | 719-203-5023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number |
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License Number State |
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