Individual
LYDIA MACKLIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
855 ANTHONY DR, ANTHONY, NM 88021
(575) 882-5706
(575) 882-2909
Mailing address
385 CALLE DE ALEGRA, BLDG A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R37028
NM
363LF0000X
Family Nurse Practitioner
Primary
CNP00803
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
343502805
MEDICARE
NM
05
—
98827529
—
NM
Enumeration date
06/21/2005
Last updated
08/28/2018
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