Individual
DR. JENNIFER MICHAL AMEZQUITA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, PMHNP-BC
Contact information
Practice address
1100 S MAIN ST STE 113, LAS CRUCES, NM 88005-2921
(915) 345-9672
Mailing address
PO BOX 130, MESILLA PARK, NM 88047-0130
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
958463
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1141317
TX
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
76270
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1141317
PMHNP-BC TX LICENSE
TX
01
—
2023103244.
ANCC BOARD CERTIFICATION
TX
01
—
76270
PMHNP-BC NM LICENSE
NM
Enumeration date
05/16/2023
Last updated
05/15/2024
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