Provider Demographics
NPI:1124130224
Name:VANCOTT, CHRISTENE (CNM CFNP)
Entity type:Individual
Prefix:
First Name:CHRISTENE
Middle Name:
Last Name:VANCOTT
Suffix:
Gender:F
Credentials:CNM CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9745 HARDROCK RD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-9338
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8600 BATAAN MEMORIAL E
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-6016
Practice Address - Country:US
Practice Address - Phone:575-373-9202
Practice Address - Fax:575-373-9592
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM323176B00000X
CARN704177363L00000X
NMCNP00702363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No176B00000XOther Service ProvidersMidwife
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM86454757Medicaid
S42814Medicare UPIN
341406206Medicare ID - Type Unspecified