Individual
MS. STACI ELIZABETH OLDHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
801 TENTH STREET, MAGDALENA, NM 87825
(575) 854-3162
Mailing address
801 TENTH STREET, MAGDALENA, NM 87825
(575) 854-3162
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
527845
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP01459
NM
Other
Enumeration date
04/22/2007
Last updated
08/31/2015
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