Provider Demographics
NPI:1992456354
Name:WOMENS CARE CLINIC OF LEA COUNTY
Entity type:Organization
Organization Name:WOMENS CARE CLINIC OF LEA COUNTY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MIRANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:YOUNG
Authorized Official - Suffix:
Authorized Official - Credentials:CFNP
Authorized Official - Phone:575-241-1211
Mailing Address - Street 1:5419 N. LOVINGTON HWY.
Mailing Address - Street 2:SUITE 35
Mailing Address - City:HOBBS
Mailing Address - State:NM
Mailing Address - Zip Code:88240
Mailing Address - Country:US
Mailing Address - Phone:575-241-1211
Mailing Address - Fax:575-241-1221
Practice Address - Street 1:5419 N. LOVINGTON HWY.
Practice Address - Street 2:SUITE 35
Practice Address - City:HOBBS
Practice Address - State:NM
Practice Address - Zip Code:88240
Practice Address - Country:US
Practice Address - Phone:575-241-1211
Practice Address - Fax:575-241-1221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-17
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty