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General NPI Number Information
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NPI Number | 1306603121
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Entity Type | Individual
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Provider Name | ELIZABETH REYES
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Gender | Female
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Dates
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Enumeration Date | 02/28/2024
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Last Update Date | 03/15/2024
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Provider Practice Location Address
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Address Line | 3900 E LOHMAN AVE STE B
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City | LAS CRUCES
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State | NM
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Zip | 88011-8268
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Country | US
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Telephone | 575-522-5752
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Fax |
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Provider Business Mailing Address
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Address Line | 7338 BLACK MESA DR
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City | EL PASO
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State | TX
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Zip | 79911-3097
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Country | US
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Telephone |
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Fax |
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 78085
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License Number State | NM
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