person
Samuel Basiaka Itie, FNP-C
Family Nurse Practitioner in Roswell, New Mexico
NPI 1952794687

Samuel Basiaka Itie is a Family Nurse Practitioner based in Roswell, NM and is specialized in Family. Samuel Basiaka Itie practices in Roswell, NM and has the professional credentials of FNP-C. The NPI Number for Samuel Basiaka Itie is 1952794687 and holds a License No. AP127554 (New Mexico).

The current practice location address for Samuel Basiaka Itie is 712 W Hobbs St, Roswell, NM and can be reached out via phone at 575-623-5263 and via fax at 575-623-5286. You can also correspond with Samuel Basiaka Itie through the mailing address at 712 W HOBBS ST, ROSWELL, NM - 88203-3646 (mailing address contact number: 575-623-5263).

Location: 712 W Hobbs St, Roswell, NM, 88203-3646
person
Provider Profile Details
NPI Number
1952794687
Provider Name
Samuel Basiaka Itie
Credential
FNP-C
Provider Entity Type
Individual
Gender
Male
Address
712 W Hobbs St, Roswell, NM, 88203-3646
Phone Number
575-623-5263
Fax Number
575-623-5286
Provider Enumeration Date
03/05/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
712 W Hobbs St
City
State
Zip
88203-3646
Phone Number
575-623-5263
Fax Number
575-623-5286
person
Provider Business Mailing Address Details
Address
712 W Hobbs St
City
State
Zip
88203-3646
Phone Number
575-623-5263
Fax Number
575-623-5286
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
License No.
69489 (New Mexico)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Psychiatric/Mental Health
Taxonomy
License No.
AP127554 (Texas)
Definition
Definition to come...
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