Individual
MICHELLE DEAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1302 E MAIN ST, TUCUMCARI, NM 88401-2508
(575) 461-2200
Mailing address
2200 W UNIVERSITY DR, PORTALES, NM 88130-9345
(505) 264-2352
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
60358
NM
Other
Enumeration date
11/11/2020
Last updated
02/10/2021
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