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General NPI Number Information
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NPI Number | 1346879574
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Entity Type | Organization
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Legal Business Name | ORGAN MOUNTAINS FAMILY & WOMEN'S HEALTH, LLC
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 12/28/2024
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Provider Practice Location Address
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Address Line | 3225 DYER ST
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City | LAS CRUCES
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State | NM
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Zip | 88011-4803
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Country | US
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Telephone | 575-888-4067
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Fax | 575-888-4067
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Provider Business Mailing Address
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Address Line | 3225 DYER ST
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City | LAS CRUCES
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State | NM
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Zip | 88011-4803
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Country | US
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Telephone | 575-888-4067
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Fax | 575-449-2425
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Authorized Official
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Title or Position | OWNER, MEMBER
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Name | JEANNE GAIL STAGNER
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Credential | CNM, FNP-C
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Telephone | 575-888-4067
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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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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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