Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | CNP-61358 | NM |
NPI | 1013523604 |
---|---|
Provider Name | Stephen Oravec |
First Address | Alamogordo, NM 88310-7868 |
Second Address | Carlsbad, NM 88220-5110 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 18/09/2020 |
Last Update Date | 30/08/2021 |