=====================================================
General NPI Number Information
=====================================================
NPI Number | 1164217923
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LEAH PARRAZ LEYVA FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 04/11/2025
-----------------------------------------------------
Last Update Date | 04/25/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2430 W PIERCE ST
-----------------------------------------------------
City | CARLSBAD
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88220-3597
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-887-4100
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 591
-----------------------------------------------------
City | LOVING
-----------------------------------------------------
State | NM
-----------------------------------------------------
Zip | 88256-0591
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 575-706-9212
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QU0200X
-----------------------------------------------------
Taxonomy Name | Urgent Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 363L00000X
-----------------------------------------------------
Taxonomy Name | Nurse Practitioner
-----------------------------------------------------
License Number | 61746
-----------------------------------------------------
License Number State | NM
-----------------------------------------------------