FOS WELLNESS LTD NPI 1982185948

NPI Information

  • NPI: 1982185948
  • Provider Name: FOS WELLNESS, LTD
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Organization
  • Doing Business As: TRINITY CHRISTIAN CARE
  • CLIA Number: 32D2188385
  • Address: 1698 S ROOSEVELT ROAD 13
    PORTALES, NM
    ZIP 88130
  • Phone: (575) 607-8702

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NPI Details

FOS WELLNESS, LTD is a family nurse practitioner in Portales, NM. FOS WELLNESS, LTD NPI is 1982185948. The provider is registered as an organization entity type.
The provider Is Doing Business As Trinity Christian Care.

The provider's business location address is:

1698 S ROOSEVELT ROAD 13
PORTALES, NM
ZIP 88130-705
Phone: (575) 607-8702
Fax: (800) 421-8110

The provider's authorized official is Rebecca Kizer .
The authorized official title is President and has the following contact phone number (575) 607-8702.

The CLIA number assigned to this NPI record is 32D2188385 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/27/2018 and was last updated on 11/4/2021.

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QP2300XClinic/CenterPrimary CareNo
2163W00000XRegistered NurseRN-72322NEW MEXICONo
3163WD0400XRegistered NurseDiabetes EducatorRN-72322NEW MEXICONo
4163WN1003XRegistered NurseNutrition SupportRN-72322NEW MEXICONo
5363LF0000XNurse PractitionerFamilyYes

What is NPI?

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This page was last updated on: 11/21/2025

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