DE BACA FAMILY PRACTICE CLINIC is a federally qualified health center (fqhc) clinic center in Fort Sumner, NM. DE BACA FAMILY PRACTICE CLINIC NPI is 1114737483. The provider is registered as an organization entity type. The provider .
The provider's business location address is:
546 N 10TH STREET FORT SUMNER, NM ZIP 88119 Phone: (575) 355-2414 Fax: (575) 355-7894
The provider's authorized official is Lisa Walraven . The authorized official title is Ceo and has the following contact phone number (575) 355-2420.
The enumeration date for this NPI number is 1/9/2025 and was last updated on 1/22/2025.
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.
This page was last updated on: 3/30/2025
NPI Synchronization or Removal
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