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Contact Information

NORTHERN NEW MEXICOORTHOPAEDIC CENTER,PC
1009 SPRUCE ST
ESPAÑOLA, NM87532-2740
 Phone: 505-747-4144
 Fax: 505-747-3213
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Surgical

363AS0400X 97 Physician Assistant
 

Medical

363AM0700X 97 Physician Assistant
 

Specialist

174400000X
 

Surgery, Foot & Ankle

213ES0103X 48 Podiatry
Indicates primary specialty

NPI Profile & details for NORTHERN NEW MEXICOORTHOPAEDIC CENTERPC · (Female)

NPI # 1043329139
Status Active
Credentials
Entity Individual
Enumeration date 08/30/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 Not specified
Identifiers
  • NM Medicaid S6078
Hospital affiliation(s) Not Available
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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