Individual
DAVID COLLADO ESTABILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
2000 W 21ST ST STE E3, CLOVIS, NM 88101
(954) 655-3570
Mailing address
PO BOX 1161, CLOVIS, NM 88102-1161
(954) 655-3570
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
264709
NC
363LF0000X
Family Nurse Practitioner
APRN-18171
SC
363LF0000X
Family Nurse Practitioner
Primary
CNP-02364
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730427014
—
NC
Enumeration date
01/22/2013
Last updated
05/30/2018
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