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Contact Information

SUSANN RAVESSOUD, NP
3500 NORTHRISE DR
LAS CRUCES, NM88011-7274
 Phone: 575-395-7246
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Acute Care

363LA2100X 50 Nurse Practitioner
 

Nurse Practitioner

363L00000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for SUSANN RAVESSOUD · (Female)

NPI # 1477543759
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 10/26/2005
Last updated 01/13/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • CA License # NP10007
  • CA License # RN430276
  • NM License # CNP-01878
  • NM License # RN-74298
  • NM Medicaid 00453277
Hospital affiliation(s)
  • GERALD CHAMPION REGIONAL MEDICAL CENTE - (Acute Care)
    2669 NORTH SCENIC DRIVE
    ALAMOGORDO, NM 88310
  • LINCOLN COUNTY MEDICAL CENTER - (Critical Access)
    211 SUDDERTH DRIVE
    RUIDOSO, NM 88345
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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