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General NPI Number Information
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NPI Number | 1578462263
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Entity Type | Organization
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Legal Business Name | HOMETOWN HEALTH CARE
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Dates
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Enumeration Date | 11/02/2026
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Last Update Date | 11/02/2026
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Provider Practice Location Address
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Address Line | 10 AVENIDA DE MOLINO
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City | ESPANOLA
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State | NM
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Zip | 87532-9865
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Country | US
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Telephone | 505-927-7912
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Fax | 505-370-2810
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Provider Business Mailing Address
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Address Line | 10 AVENIDA DE MOLINO
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City | ESPANOLA
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State | NM
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Zip | 87532-9865
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Country | US
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Telephone | 505-927-7912
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Fax | 505-370-2810
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Authorized Official
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Title or Position | NURSE PRACTITIONER
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Name | TERRY WATERS
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Credential | FNP-C, CARN-AP
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Telephone | 505-927-7912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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