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Logan Family Practice, Llc
Family Nurse Practitioner in Logan, New Mexico
NPI 1902044597

Logan Family Practice, Llc is a Family Nurse Practitioner based in Logan, NM and is specialized in Family. Logan Family Practice, Llc practices in Logan, NM. The NPI Number for Logan Family Practice, Llc is 1902044597 and holds a License No. R14626 (New Mexico).

The current practice location address for Logan Family Practice, Llc is 600 Gallegos, Logan, NM and can be reached out via phone at 575-487-9000 and via fax at 575-487-9002.

Location: 600 Gallegos, Logan, NM, 88426-7602
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1902044597
Provider Name
Logan Family Practice, Llc
Credential
Provider Entity Type
Organization
Address
600 Gallegos, Logan, NM, 88426-7602
Phone Number
575-487-9000
Fax Number
575-487-9002
Provider Enumeration Date
02/04/2009
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
28184564 05 NM
institution
Provider Business Practice Location Address Details
Address
600 Gallegos
City
Logan
State
New Mexico
Zip
88426-7602
Phone Number
575-487-9000
Fax Number
575-487-9002
person
Provider Business Mailing Address Details
Address
600 Gallegos
City
Logan
State
New Mexico
Zip
88426-7602
Phone Number
575-487-9000
Fax Number
575-487-9002
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Primary Care
Taxonomy
261QP2300X
License No.
R14626 (New Mexico)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
R14626 (New Mexico)
Definition
Definition to come...
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