# LIFTED CLINICAL PRACTICE, PLLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1447797758
- **Authorized official:** DR. FUNMILAYO AINA DNP,FNP-C (FAMILY NURSE PRACTITIONER)
- **Authorized official phone:** (505) 430-0760

## Contact information

- **Practice address:** 2801 RODEO RD STE C14, SANTA FE, NM 87507-6503
- **Practice address phone:** (505) 430-0760
- **Practice address fax:** (866) 354-3833
- **Mailing address:** 2801 RODEO RD STE C14, SANTA FE, NM 87507-6503
- **Mailing address phone:** (505) 430-0760
- **Mailing address fax:** (866) 354-3833

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QC1500X | Community Health Clinic/Center | 688447 | TX | Yes |
| 261QC1500X | Community Health Clinic/Center | AP123182 | TX | — |

## Other

- **Enumeration date:** 01/24/2017
- **Last updated:** 09/08/2022