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General NPI Number Information
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NPI Number | 1558051425
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Entity Type | Individual
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Provider Name | BERNICE BECERRA MSN, PMHNP
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Gender | Female
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Dates
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Enumeration Date | 05/12/2023
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Last Update Date | 05/12/2023
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Provider Practice Location Address
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Address Line | 3080 BRELAND DR
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City | LAS CRUCES
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State | NM
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Zip | 88003
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Country | US
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Telephone | 575-646-8306
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 24058
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City | EL PASO
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State | TX
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Zip | 79914-0058
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Country | US
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Telephone | 915-487-1604
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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 | 73382
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License Number State | NM
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