Individual
MALLORY MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
912 W 21ST ST, CLOVIS, NM 88101-4149
(575) 935-9000
(575) 935-1002
Mailing address
912 W 21ST ST, CLOVIS, NM 88101-4149
(575) 935-9000
(575) 935-1002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
90737
NM
Other
Enumeration date
07/23/2026
Last updated
07/23/2026
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