Small Town Family Practice Llc

LBN: Small Town Family Practice Llc
Small Town Family Practice Llc is an health care organization with primary practice located at 4225 Montgomery Blvd Ne , Albuquerque NM 87109-1103. The organization recently has 5 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Allopathic & Osteopathic Physicians / Family Medicine, Ambulatory Health Care Facilities / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Ambulatory Health Care Facilities / Primary Care is the primary health care specialty. Small Town Family Practice Llc can be contacted via phone (505) 366-3635, or through Clark, Deanna Rene via phone (505) 366-3635.

Contact Information

Primary practice address
4225 Montgomery Blvd Ne Albuquerque NM 87109-1103
Phone: (505) 366-3635
Fax: (505) 221-5429
Website:
Map and Directions
Authorized official contact:
Name: Clark, Deanna Rene NURSE PRACTITIONER
Phone: (505) 366-3635

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X
Ambulatory Health Care Facilities / Primary Care 261QP2300X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X

Profile Details

NPI number 1164194940
LBN Legal business name Small Town Family Practice Llc
DBA Doing business as
Authorized official Clark, Deanna Rene NURSE PRACTITIONER
Entity Organization
Organization subpart 1 No
Enumeration date Sep 30th, 2021
Last updated Sep 30th, 2021 - about 3 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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