Individual provider · Type 1 NPI

Mallory Maxwell, FNP

Nurse Practitioner · Clovis, NM

NPI number 1609797679 Active

Practice location

912 W 21st St
Clovis, NM 88101-4149

Call (575) 935-9000 Map

Fax (575) 935-1002

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X90737 (NM)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1609797679

Mallory Maxwell, FNP's National Provider Identifier is 1609797679, issued on Jul 23, 2026. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Clovis, NM. The record was last updated on Jul 23, 2026.