Individual
MS. WHITNEY E WYERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
211 SUDDERTH DR, RUIDOSO, NM 88345-6002
(575) 257-8200
(575) 630-4237
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-03498
NM
363LF0000X
Family Nurse Practitioner
CNP-03498
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
17522854
—
NM
Enumeration date
02/14/2018
Last updated
02/04/2022
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