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General NPI Number Information
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NPI Number | 1194553024
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Entity Type | Organization
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Legal Business Name | CURBSIDE WELLNESS CLINIC LLC
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Dates
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Enumeration Date | 07/23/2024
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Last Update Date | 10/11/2025
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Provider Practice Location Address
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Address Line | 921 E 21ST ST STE E
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City | CLOVIS
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State | NM
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Zip | 88101-4443
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Country | US
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Telephone | 575-221-9663
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Fax |
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Provider Business Mailing Address
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Address Line | 921 E 21ST ST STE E
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City | CLOVIS
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State | NM
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Zip | 88101-4443
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Country | US
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Telephone | 978-259-3966
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Fax | 575-935-2412
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Authorized Official
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Title or Position | OWNER/NURSE PRACTITIONER
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Name | JESSICA SIMPSON
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Credential | FNP-C
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Telephone | 575-221-9663
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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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