MEDICARE: TANIA DANETTE BILLSTONE-SIMPSON MSN, APRN, FNP-C

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	59015	NM

General Provider Information

NPI Number	:	1902437999
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TANIA DANETTE BILLSTONE-SIMPSON MSN, APRN, FNP-C

Provider Business Mailing Address
First Line	:	5275 SINGER RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88007-5566
Country	:	US
Telephone Number	:	575-915-4230
Fax Number	:

Provider Business Practice Location Address
First Line	:	3870 FOOTHILLS RD
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88011-4631
Country	:	US
Telephone Number	:	575-800-0645
Fax Number	:

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

Provider Enumeration Date	:	01/29/2020
Last Update Date	:	05/10/2024

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