Individual
AMANDA DEATHERAGE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1600 W AVENUE I, LOVINGTON, NM 88260-5002
(806) 928-9870
(806) 243-6233
Mailing address
901 W WILDY ST, ROSWELL, NM 88203-3717
(806) 928-9870
(806) 243-6233
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
1070110
TX
363LF0000X
Family Nurse Practitioner
Primary
67588
NM
Other
Enumeration date
02/16/2022
Last updated
05/26/2026
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