Organization
LAURA SMITH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LEONR VASQUEZ (CREDENTIALING SPECIALIST)
(575) 525-8484
Entity
Organization
Contact information
Practice address
250 S MAIN ST, LAS CRUCES, NM 88001-1278
(575) 525-8484
(575) 449-2445
Mailing address
2444 E SOUTHERN AVE STE 103, MESA, AZ 85204-5418
(701) 404-7550
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
01/27/2017
Last updated
01/27/2017
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