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NPI Code Detail

MEDICARE: MS. JUDITH L. BIXBY RN

MEDICARE: MS. JUDITH L. BIXBY RN
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
1163WC1500XCommunity Health Registered Nurse35615NM

General Provider Information

NPI Number : 1447282769
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JUDITH L. BIXBY RN
Provider Business Mailing Address
First Line : 2607 CRESTVIEW DR
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-4507
Country : US
Telephone Number : 505-522-6543
Fax Number :
Provider Business Practice Location Address
First Line : 100 W GRIGGS AVE
Second Line :
City : LAS CRUCES
State : NM
Zip : 88001-1234
Country : US
Telephone Number : 505-647-2800
Fax Number : 505-647-2898
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2006
Last Update Date : 07/08/2007

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