Diana Portillo CNP

NPI 1194049841 - Nurse Practitioner - 363LF0000X

NPI Details
NPI 1194049841
Gender Female
Enumeration Date 03/24/2010
Last Updated 02/25/2016
Entity Type Individual
Active Over 6 years ago
Practice Location
18420 S. HIGHWAY 28
SAN MIGUEL NM, 88058, US
Phone (575) 233-3830
Fax (575) 233-4542
Business Location
385 CALLE DE ALEGRA
BLDG. A
LAS CRUCES NM, 88005-3423, US
Phone (575) 526-1105
Fax (575) 267-1747
Toxanomy
Taxonomy Code 363LF0000X
License State New Mexico
License Number CNP-01613
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According to our database, Diana Portillo CNP NPI is 1194049841, taxonomy code is 363LF0000X and license number is CNP-01613, license state is located at New Mexico. Diana Portillo CNP physically located at 18420 S. Highway 28, San Miguel NM, 88058. NPI Number Diana Portillo CNP has the Individual type.

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1194049841 NPI number is provided on an as is basis without warranty of any kind. 1194049841 is maintained by the National Plan & Provider Enumeration System. The contents of Diana Portillo CNP are for informational purposes only.