Provider Demographics
NPI:1063882058
Name:NOR LEA GENERAL HOSPITAL
Entity type:Organization
Organization Name:NOR LEA GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FNP/NURSE PRACTITIONER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KELLI
Authorized Official - Middle Name:ELIZABETH
Authorized Official - Last Name:MCCALL
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:575-631-2336
Mailing Address - Street 1:1125 W BRITTANY DR
Mailing Address - Street 2:
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88242-9706
Mailing Address - Country:US
Mailing Address - Phone:575-396-5059
Mailing Address - Fax:575-396-1454
Practice Address - Street 1:1600 N MAIN AVE
Practice Address - Street 2:
Practice Address - City:LOVINGTON
Practice Address - State:NM
Practice Address - Zip Code:88260-2830
Practice Address - Country:US
Practice Address - Phone:575-396-5059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02768282NR1301X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282NR1301XHospitalsGeneral Acute Care HospitalRural