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General NPI Number Information
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NPI Number | 1164445136
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Entity Type | Organization
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Legal Business Name | PHC-LAS CRUCES INC
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Dates
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Enumeration Date | 07/25/2006
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 2450 S TELSHOR BLVD
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City | LAS CRUCES
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State | NM
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Zip | 88011-5069
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Country | US
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Telephone | 575-522-8641
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Fax | 575-521-5013
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Provider Business Mailing Address
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Address Line | PO BOX 6310
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City | LAS CRUCES
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State | NM
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Zip | 88006-6310
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Country | US
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Telephone | 575-521-5370
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Fax | 575-521-5376
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Authorized Official
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Title or Position | SECRETARY
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Name | CHARLOTTE LAWRENCE
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Credential |
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Telephone | 615-920-7688
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number |
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License Number State |
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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 |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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Taxonomy #8
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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Taxonomy #9
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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