Individual
NANCY A LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5141
(575) 556-5890
Mailing address
4072 DEMOS AVE, LAS CRUCES, NM 88011-4209
(973) 807-6446
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
54914
NM
363LG0600X
Gerontology Nurse Practitioner
Primary
54914
NM
Other
Enumeration date
01/08/2019
Last updated
08/09/2019
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