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Individual

RICKEY I TABOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1600 NORTH MAIN, LOVINGTON, NM 88260-2813
(575) 396-3529
(575) 396-1454
Mailing address
1600 NORTH MAIN, LOVINGTON, NM 88260-2813
(575) 396-3529
(575) 396-1454

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R15408
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
89485262
NM
Enumeration date
06/26/2006
Last updated
04/03/2014
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