Individual
JENNIFER DEROY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2150 HIGHWAY 54 S, ALAMOGORDO, NM 88310-7330
(575) 443-8133
(575) 443-8055
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3280
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP00916
NM
363LF0000X
Family Nurse Practitioner
R41076
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
49626248
—
NM
Enumeration date
03/08/2006
Last updated
08/01/2011
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