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General NPI Number Information
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NPI Number | 1649330325
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Entity Type | Organization
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Legal Business Name | BESTCARE FAMILY MEDICAL SERVICES
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2701 W PICACHO AVE SUITE 8
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City | LAS CRUCES
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State | NM
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Zip | 88007-4775
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Country | US
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Telephone | 505-527-2300
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Fax | 505-527-2302
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Provider Business Mailing Address
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Address Line | 2701 W PICACHO AVE SUITE 8
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City | LAS CRUCES
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State | NM
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Zip | 88007-4775
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Country | US
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Telephone | 505-527-2300
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Fax | 505-527-2302
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Authorized Official
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Title or Position | OWNER
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Name | MICHAEL JEFFREY O'CONNELL
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Credential | FNP-C
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Telephone | 505-527-2300
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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 | R37541
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License Number State | NM
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