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General NPI Number Information
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NPI Number | 1467293258
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Entity Type | Individual
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Provider Name | CHRISTY LYNN PONCE APRN-CNP
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Gender | Female
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Dates
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Enumeration Date | 06/04/2024
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Last Update Date | 06/04/2024
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Provider Practice Location Address
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Address Line | 121 E REDD RD
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City | EL PASO
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State | TX
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Zip | 79932-1981
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Country | US
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Telephone | 915-584-8882
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Fax |
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Provider Business Mailing Address
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Address Line | 1721 LAND RUSH ST
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City | EL PASO
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State | TX
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Zip | 79911-3104
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Country | US
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Telephone | 915-861-9655
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 1158240
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License Number State | TX
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