Organization
ACTIVE MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASHLEY JORDAN SMITH NP (NURSE PRACTITIONER)
(505) 336-7344
Entity
Organization
Contact information
Practice address
4801 N BUTLER AVE STE 8102, FARMINGTON, NM 87401-0818
(505) 370-1201
(505) 461-1779
Mailing address
4801 N BUTLER AVE STE 8102, FARMINGTON, NM 87401-0818
(505) 370-1201
(505) 461-1779
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/23/2023
Last updated
01/16/2025
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