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NPI Code Detail

MEDICARE: LAUREN ELISE PINCOMB APODACA

MEDICARE:   LAUREN ELISE PINCOMB APODACA
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
1363A00000XPhysician AssistantPA2022-0123NM

General Provider Information

NPI Number : 1902405442
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAUREN ELISE PINCOMB APODACA
Provider Business Mailing Address
First Line : 2325 1/2 BURKE RD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-5012
Country : US
Telephone Number : 575-932-8167
Fax Number :
Provider Business Practice Location Address
First Line : 2325 1/2 BURKE RD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88007-5012
Country : US
Telephone Number : 575-932-8167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2020
Last Update Date : 02/17/2023

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Directions to “ LAUREN ELISE PINCOMB APODACA ” Practice Location

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