Organization
SOUTHWEST WELLNESS
Active
Other names
La Clinica
Organization subpart
No
Provider details
NPI number
Authorized official
SHAUNA MICHELLE MCCOSH CNP, CNM (OWNER)
(575) 388-4251
Entity
Organization
Contact information
Practice address
3201 N RIDGE LOOP DR, SILVER CITY, NM 88061-7243
(575) 388-4251
(575) 388-4514
Mailing address
3201 N RIDGE LOOP DR, SILVER CITY, NM 88061-7243
(575) 388-4251
(575) 388-4514
Taxonomy
Speciality
Code
Description
License number
State
261QB0400X
Birthing Clinic/Center
588
NM
261QP2300X
Primary Care Clinic/Center
Primary
CNP01356
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000S6635
—
NM
Enumeration date
01/30/2014
Last updated
01/30/2014
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