Organization
FOS WELLNESS, LTD
Active
Parent organization
FOS WELLNESS, LTD
Other names
Trinity Christian Care
Organization subpart
Yes
Provider details
NPI number
Legal business name
FOS WELLNESS, LTD
Authorized official
MRS. REBECCA KIZER MSN, FNP-BC, CFNC (PRESIDENT)
(575) 607-8702
Entity
Organization
Contact information
Practice address
1698 S ROOSEVELT ROAD 13, PORTALES, NM 88130-8705
(575) 607-8702
(800) 421-8110
Mailing address
1698 S ROOSEVELT ROAD 13, PORTALES, NM 88130-8705
(575) 607-8702
(800) 421-8110
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN-72322
NM
163WD0400X
Diabetes Educator Registered Nurse
RN-72322
NM
163WN1003X
Nutrition Support Registered Nurse
RN-72322
NM
261QP2300X
Primary Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/27/2018
Last updated
11/04/2021
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