Individual
ANDREA DIANE CARRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2402 W PIERCE ST STE 6A, CARLSBAD, NM 88220-3566
(575) 706-5887
Mailing address
2410 N FOWLER ST, HOBBS, NM 88240-2312
(575) 392-2040
(575) 392-6752
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
54911
NM
Other
Enumeration date
02/01/2019
Last updated
05/13/2019
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