MEDICARE: MRS. FATIMA MCELVEEN DNP, AGPCNP, PMHNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2200X	Adult Health Nurse Practitioner	18187	TN
2	363LG0600X	Gerontology Nurse Practitioner	18187	TN
3	363LA2200X	Adult Health Nurse Practitioner	CNP-02397	NM

General Provider Information

NPI Number	:	1154752616
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. FATIMA MCELVEEN DNP, AGPCNP, PMHNP

Provider Business Mailing Address
First Line	:	PO BOX 2243
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88004-2243
Country	:	US
Telephone Number	:	575-527-5482
Fax Number	:	575-652-4243

Provider Business Practice Location Address
First Line	:	999 W AMADOR AVE STE A
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-2739
Country	:	US
Telephone Number	:	575-527-5482
Fax Number	:	575-652-4243

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/10/2013
Last Update Date	:	11/29/2022

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