MEDICARE: MS. ELIZABETH GAIL KUCHLER APRN-BC FNP

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	363LF0000X	Family Nurse Practitioner	R22072	NM
2	363LF0000X	Family Nurse Practitioner	CNP00375	NM

General Provider Information

NPI Number	:	1215984174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ELIZABETH GAIL KUCHLER APRN-BC FNP

Provider Business Mailing Address
First Line	:	1920 TURRENTINE DR
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3347
Country	:	US
Telephone Number	:	505-541-8660
Fax Number	:

Provider Business Practice Location Address
First Line	:	1920 TURRENTINE DR
Second Line	:	540 WALTON SUITE C
City	:	LAS CRUCES
State	:	NM
Zip	:	88005-3347
Country	:	US
Telephone Number	:	505-541-8660
Fax Number	:

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

Provider Enumeration Date	:	05/27/2006
Last Update Date	:	09/09/2020

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