Individual
NICK NEVARES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3377 PARK RIDGE PL, LAS CRUCES, NM 88005-1106
(575) 524-0732
Mailing address
3377 PARK RIDGE PL, LAS CRUCES, NM 88005-1106
(575) 524-0732
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
M-4493
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
M-4493
LICENSE SOCIAL WORKER
NM
Enumeration date
05/06/2013
Last updated
05/06/2013
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