Organization
HALCYON HEALTH OF THE SOUTHWEST, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISTI LYNN FNP-C (OWNER / PROVIDER)
(931) 636-6648
Entity
Organization
Contact information
Practice address
1355 CALIFORNIA AVE STE B, LAS CRUCES, NM 88001
(575) 523-8951
(575) 366-8011
Mailing address
1355 CALIFORNIA AVE STE B, LAS CRUCES, NM 88001-4187
(575) 523-8951
(575) 366-8011
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-02392
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64634876
—
NM
Enumeration date
08/08/2018
Last updated
12/06/2018
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