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NPI 1164396123

NPI 1164396123 : FELICIA ACOSTA CHW : SILVER CITY, NM

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General NPI Number Information
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    NPI Number           |    1164396123
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    Entity Type          |    Individual 
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    Provider Name        |    FELICIA ACOSTA CHW
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    10/02/2025
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    Last Update Date     |    10/02/2025
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Provider Practice Location Address
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    Address Line         |    1311 N GRANT ST STE A 
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    City                 |    SILVER CITY
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    State                |    NM
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    Zip                  |    88061-5134
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    Country              |    US
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    Telephone            |    575-388-1447
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    Fax                  |    575-388-1447
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Provider Business Mailing Address
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    Address Line         |    1311 N GRANT ST STE A 
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    City                 |    SILVER CITY
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    State                |    NM
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    Zip                  |    88061-5134
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    Country              |    US
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    Telephone            |    575-388-1447
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    Fax                  |    575-388-1447
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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        |    172V00000X
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    Taxonomy Name        |    Community Health Worker
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    License Number       |    G-1843
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    License Number State |    NM
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