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General NPI Number Information
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NPI Number | 1477440576
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Entity Type | Organization
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Legal Business Name | NEW MEXICO CORRECTIONS DEPARTMENT - HSD
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Dates
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Enumeration Date | 06/20/2025
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Last Update Date | 06/20/2025
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Provider Practice Location Address
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Address Line | 4337 STATE HIGHWAY 14
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City | SANTA FE
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State | NM
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Zip | 87508-1530
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Country | US
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Telephone | 505-629-5573
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Fax |
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Provider Business Mailing Address
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Address Line | 4337 STATE HIGHWAY 14
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City | SANTA FE
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State | NM
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Zip | 87508-1530
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Country | US
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Telephone | 505-629-5573
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Fax |
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Authorized Official
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Title or Position | BUREAU CHIEF
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Name | GREG NELSON
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Credential |
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Telephone | 505-331-8562
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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