Individual
LAURIE DANIELLE CROCKETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
702 N 13TH ST, ARTESIA, NM 88210-1166
(575) 746-3119
(575) 746-4295
Mailing address
702 N 13TH ST, ARTESIA, NM 88210-1199
(575) 746-3119
(575) 746-4295
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
59186
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
99702096
—
NM
Enumeration date
02/04/2020
Last updated
09/24/2021
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