Individual
MRS. MIKI R MOFFITT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, BSN, FNP-C
Contact information
Practice address
102 LLANO ST, AZTEC, NM 87410-2172
(505) 334-3404
Mailing address
PO BOX 844088, DALLAS, TX 75284-4088
(505) 334-3404
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
R41419
NM
363LF0000X
Family Nurse Practitioner
Primary
85672
NM
Other
Enumeration date
03/13/2014
Last updated
11/21/2025
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