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Contact Information

CLAY CHURCH, NP
801 W MAPLE ST
FARMINGTON, NM87401-5630
 Phone: 505-609-2000
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for CLAY CHURCH · (Male)

NPI # 1083264592
Status Active
Credentials NP (Nurse Practitioner)
Entity Individual
Enumeration date 09/17/2019
Last updated 09/17/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • NM License # 57227
Hospital affiliation(s)
  • SAN JUAN REGIONAL MEDICAL CENTER - (Acute Care)
    801 WEST MAPLE STREET
    FARMINGTON, NM 87401
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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