Portillo, Diana
Portillo, Diana is an individual health care provider with primary practice located at 330 N Campo St , Las Cruces NM 88001-3433. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Portillo, Diana can be contacted via phone (575) 288-1336.Contact Information
Primary practice address
330 N Campo St
Las Cruces NM 88001-3433
Phone: (575) 288-1336
Fax: (575) 222-4453
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X | CNP-01613 | New Mexico |
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | CNP-01613 | New Mexico |
Profile Details
NPI number | 1194049841 |
---|---|
LBN Legal business name | Portillo, Diana |
Credentials | DNP, FNP-C, PMHNP-BC |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 24th, 2010 |
Last updated | Oct 2nd, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1194049841 | NPPES |
New Mexico | MEDICAID | 20636865 | |
New Mexico | Other | NMA100470 |
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