Individual
DR. JESSICA LISE DAUPHIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
(575) 521-5385
Mailing address
2450 S TELSHOR BLVD, LAS CRUCES, NM 88011-5069
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
RS2022-0697
NM
390200000X
Student in an Organized Health Care Education/Training Program
RS2022-0697
NM
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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