Individual
DIANNE C WILSON MCELYEA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2701 MISSOURI AVE, STE A, LAS CRUCES, NM 88011-5091
(575) 522-7880
(575) 522-7226
Mailing address
5528 KALAHARI LN, LAS CRUCES, NM 88011-7252
(480) 280-5400
(505) 532-8910
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R34632
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R34632
LICENSE
NM
Enumeration date
12/28/2006
Last updated
07/16/2009
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