Organization · Type 2 NPI

Fos Wellness, Ltd

Family Nurse Practitioner · Portales, NM

NPI number 1982185948 Active

Practice location

1698 S Roosevelt Road 13
Portales, NM 88130-8705

Call (575) 607-8702 Map

Fax (800) 421-8110

Other practice locations

1812 S Roosevelt Road 8, Portales, NM 88130-9724 · (575) 607-8702

Specialties and licenses

Taxonomy	Code	License
Registered Nurse	163W00000X	RN-72322 (NM)
Diabetes Educator Registered Nurse	163WD0400X	RN-72322 (NM)
Nutrition Support Registered Nurse	163WN1003X	RN-72322 (NM)
Primary Care Clinic/Center	261QP2300X	None listed
Family Nurse Practitioner Primary	363LF0000X	None listed

Family Nurse Practitioner: Definition to come...

NPI record

NPI: 1982185948
Entity type: Organization (Type 2)
Issued: Aug 27, 2018
Last updated: Nov 4, 2021
Status: Active
Subpart: Yes of Fos Wellness, Ltd

Other names

<unavail>
Trinity Christian Care · doing business as
Trinity Christian Care · doing business as

Authorized official

Mrs. Rebecca Kizer, MSN, FNP-BC, CFNC
President
(575) 607-8702

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1982185948

Fos Wellness, Ltd's National Provider Identifier is 1982185948, issued on Aug 27, 2018. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Portales, NM. The record was last updated on Nov 4, 2021.