Individual
MELISSA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
165 N COLLISON AVE, CIMARRON, NM 87714-8505
(575) 376-2445
Mailing address
PO BOX 63, CIMARRON, NM 87714-0063
(575) 447-5090
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L17496
NM
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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