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General NPI Number Information
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NPI Number | 1205632601
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Entity Type | Organization
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Legal Business Name | ASPEN FAMILY CLINIC, LLC
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Dates
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Enumeration Date | 02/25/2025
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1214 MECHEM DR
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City | RUIDOSO
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State | NM
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Zip | 88345-7206
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Country | US
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Telephone | 817-201-3958
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Fax |
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Provider Business Mailing Address
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Address Line | 1214 MECHEM DR
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City | RUIDOSO
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State | NM
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Zip | 88345-7206
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Country | US
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Telephone | 817-201-3958
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Fax | 575-616-7466
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Authorized Official
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Title or Position | OWNER
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Name | NANCY WALKER
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Credential | CNP
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Telephone | 817-201-3859
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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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