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General NPI Number Information
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NPI Number | 1447734165
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Entity Type | Individual
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Provider Name | DENAI LYNN FORREST DNP APRN-CNP PMHNP
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Gender | Female
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Dates
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Enumeration Date | 09/19/2018
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Last Update Date | 10/07/2019
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Provider Practice Location Address
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Address Line | 19478 HIGHWAY 314
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City | BELEN
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State | NM
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Zip | 87002-8223
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Country | US
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Telephone | 505-357-4385
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Fax |
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Provider Business Mailing Address
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Address Line | 1224 SILVA RD
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City | BELEN
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State | NM
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Zip | 87002-7563
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Country | US
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Telephone | 505-314-4966
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 53911
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License Number State | NM
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