Individual
MICHAEL JEFFREY O'CONNELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CFNP
Contact information
Practice address
2435 S TELSHOR BLVD, LAS CRUCES, NM 88011-5029
(575) 522-7798
(575) 522-3415
Mailing address
PO BOX 691, MESILLA, NM 88046-0691
(575) 636-5019
(575) 522-3415
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R37541
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
NM016345
BLUE CROSS BLUE SHIELD
NM
05
—
S9749
—
NM
Enumeration date
05/27/2005
Last updated
09/15/2023
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