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SOUTHWEST HEART PC NPI 1265502298


NPI Information

NPI: 1265502298
Provider Name: SOUTHWEST HEART PC
Classification: Clinical Nurse Specialist - 364SA2200X
Entity Type: Organization

Specialization: Adult Health

Address:
4351 E LOHMAN AVE STE 405
LAS CRUCES, NM
ZIP 88011
Phone: (575) 522-2233
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SOUTHWEST HEART PC is an adult health clinical nurse specialist in Las Cruces, NM. SOUTHWEST HEART PC NPI is 1265502298. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4351 E LOHMAN AVE STE 405
LAS CRUCES, NM
ZIP 88011-261
Phone: (575) 522-2233
Fax: (575) 522-2266

The provider's authorized official is Terry A Boulware .
The authorized official title is Owner and has the following contact phone number (505) 522-7247.

The enumeration date for this NPI number is 11/8/2006 and was last updated on 1/22/2020.


Taxonomy Codes

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:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1364SA2200XClinical Nurse SpecialistAdult HealthYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
156428006MEDICAIDNEW MEXICO

What is NPI?

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: 4/28/2024

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