SAMUEL CORREA BUSTILLOS (NPI# 1699289173) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699289173 |
| Entity Type | Individual |
| Full Name | SAMUEL CORREA BUSTILLOS |
| Credential | ACNP-AG |
| Practice Address |
2450 S Telshor Blvd Las Cruces NM 88011-5141 |
| Mailing Address |
4672 Sonoma Ranch Blvd # A&b Las Cruces NM 88011-7167 |
| Practice Telephone | 5756367407 |
| Mailing Telephone | 5755561879 |
| Mailing Fax Number | 5755561880 |
| Enumeration Date | 2017-11-20 |
| Last Update Date | 2018-01-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2100X |
Nurse Practitioner Specialization: Acute Care |
CNP-03431 | NM | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2450 S TELSHOR BLVD |
| City | LAS CRUCES |
| State | NM |
| Zip Code | 88011-5141 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619973187 | Jenifer Lichtenfels | Pediatrics | 2450 S Telshor Blvd, Las Cruces, NM 88011-5141 | 2005-06-21 |
| 1669080560 | Leonard Nathaniel Sampath | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-07-16 |
| 1396362034 | Sartaj Singh Brar | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-29 |
| 1497372387 | Alexander Topete | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5076 | 2020-06-26 |
| 1619594421 | Eva Roxanna Campos | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-26 |
| 1437774759 | Bryan Wellington Messenger | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-12 |
| 1558986745 | Anthony Cohn | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5076 | 2020-06-12 |
| 1205451739 | Elena Liang Liang | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-10 |
| 1750906285 | Nagapavani Kandagari | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-10 |
| 1205450293 | Temitope Ade-oshifogun | Family Medicine | 2450 S Telshor Blvd, Las Cruces, NM 88011-5069 | 2020-06-04 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356954648 | Asc of The Heart Institute | Internal Medicine | 1250 N Sonoma Ranch Blvd, Las Cruces, NM 88011 | 2020-08-26 |
| 1104449206 | Kruti Gitesh Shah | Student in an Organized Health Care Education/Training Program | Mountain View Regional Medical Cente, Graduate Medical Education, 4351 E Lohman Ave Suite 300, Las Cruces, NM 88011 | 2020-05-22 |
| 1831719368 | Borna Mansouri | Student in an Organized Health Care Education/Training Program | 4351 E. Lahman Ave, Suite 300, Moutnainview Regional Medical Center Graduta, Las Cruces, NM 88011 | 2020-04-24 |
| 1306474408 | Madonna Petula Phillip | Student in an Organized Health Care Education/Training Program | 4351 E Lohmon Avenue Suite 300, Las Cruces, NM 88011 | 2020-04-01 |
| 1285267849 | Back In Action Therapy of Las Cruces | Occupational Therapist | 4440 Sonoma Ranch Blvd, Suite F, Las Cruces, NM 88011 | 2020-02-21 |
| 1649818725 | Kimberly Ann Smetzer | Registered Nurse | 4401 East Lohman, Building 5, Las Cruces, NM 88011 | 2019-12-19 |
| 1548806375 | Melinda Michelle Fowler | Social Worker | 2605 Terrace Drive, Las Cruces, NM 88011 | 2019-11-27 |
| 1871134692 | Rio Grande Hematology and Oncology, LLC | Internal Medicine | 4391 East Lohman Ave., Las Cruces, NM 88011 | 2019-10-02 |
| 1972083640 | Lorianna R. Narvaez | Counselor | 1155 S. Telshor Suite 302-a, Las Cruces, NM 88011 | 2018-08-21 |
| 1215416524 | Aday Orthodontics, PC | Dentist | 2701 Missouri Ave., Suite D, Las Cruces, NM 88011 | 2018-08-08 |
| Find all providers in zip 88011 | ||||
| Taxonomy Code | 363LA2100X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Acute Care |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235636820 | Danielle Marie Ruiz | Nurse Practitioner | 2525 S Telshor Blvd Ste 102, Las Cruces, NM 88011-9148 | 2018-04-10 |
| 1891198081 | Patrick Garcia | Nurse Practitioner | 5819 Coyote Peak Place, Las Cruces, NM 88012 | 2014-10-01 |
| 1942367271 | Mary Ellen Hunner | Nurse Practitioner | 2530 S. Telshor Blvd., Suite 201, Las Cruces, NM 88011 | 2007-01-03 |
| 1215568076 | Tracey L Nutter | Nurse Practitioner | 2450 S Telshor Blvd, Las Cruces, NM 88011-5076 | 2020-01-30 |
| 1144865510 | Matthew Franco | Nurse Practitioner | 4311 E Lohman Ave, Las Cruces, NM 88011-8255 | 2019-11-08 |
| 1093178766 | Jaime Sanchez | Nurse Practitioner | 8175 Constitution Rd, Las Cruces, NM 88007-8984 | 2016-03-31 |
| 1982080347 | Marcia Watts Hammons | Nurse Practitioner | 1160 Mall Dr, Las Cruces, NM 88011-8128 | 2015-08-07 |
| 1275923286 | Nicholas Riburn Vaughn | Nurse Practitioner | 2450 S Telshor Blvd, Las Cruces, NM 88011-5141 | 2015-01-28 |
| 1588081822 | Laurence Jerome Labayen | Nurse Practitioner | 2450 S Telshor Blvd, Las Cruces, NM 88011-5141 | 2014-03-25 |
| 1396176319 | Selene Marie Reyes | Nurse Practitioner | 2525 S Telshor Blvd, Suite B2, Las Cruces, NM 88011-5071 | 2013-12-01 |
| Find all providers in LAS CRUCES | ||||
| City | LAS CRUCES |
| Zip Code | 88011 |
Please comment or provide details below to improve the information on SAMUEL CORREA BUSTILLOS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.