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Individual

PAMELA AMMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
166 HOSPITAL DR, RATON, NM 87740-2002
(575) 445-3626
(877) 559-2708
Mailing address
117 CAMINO DE VIDA SUITE 300, SANTA ROSA, NM 88435
(575) 472-4311
(575) 472-4313

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-55628
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
49574744
NM
01
821448
MEDICARE
NM
Enumeration date
05/06/2019
Last updated
02/15/2024
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