Individual
KRISTA NANETTE MERICLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
117 CAMINO DE VIDA STE 300, SANTA ROSA, NM 88435-2267
(575) 472-4311
(877) 651-0289
Mailing address
117 CAMINO DE VIDA STE 300, SANTA ROSA, NM 88435-2267
(575) 472-4311
(877) 651-0289
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
NM-73375
NM
363LF0000X
Family Nurse Practitioner
Primary
CNP-73289
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
E7582
—
NM
Enumeration date
11/18/2016
Last updated
05/19/2023
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