Provider Demographics
NPI:1154752616
Name:MCELVEEN, FATIMA (DNP, AGPCNP, PMHNP)
Entity type:Individual
Prefix:MRS
First Name:FATIMA
Middle Name:
Last Name:MCELVEEN
Suffix:
Gender:F
Credentials:DNP, AGPCNP, PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2243
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88004-2243
Mailing Address - Country:US
Mailing Address - Phone:575-527-5482
Mailing Address - Fax:575-652-4243
Practice Address - Street 1:999 W AMADOR AVE STE A
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88005-2739
Practice Address - Country:US
Practice Address - Phone:575-527-5482
Practice Address - Fax:575-652-4243
Is Sole Proprietor?:No
Enumeration Date:2013-12-10
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN18187363LA2200X, 363LG0600X
NMCNP-02397363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology