Provider Demographics
NPI:1235427527
Name:ORTIZ, TRISHA LYNN
Entity Type:Individual
Prefix:MRS
First Name:TRISHA
Middle Name:LYNN
Last Name:ORTIZ
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:TRISHA
Other - Middle Name:LYNN
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1349
Mailing Address - Street 2:
Mailing Address - City:SILVER CITY
Mailing Address - State:NM
Mailing Address - Zip Code:88062-1349
Mailing Address - Country:US
Mailing Address - Phone:575-388-4497
Mailing Address - Fax:575-534-1150
Practice Address - Street 1:315 S. HUDSON ST.
Practice Address - Street 2:
Practice Address - City:SILVER CITY
Practice Address - State:NM
Practice Address - Zip Code:88061-6184
Practice Address - Country:US
Practice Address - Phone:575-388-4497
Practice Address - Fax:575-534-1150
Is Sole Proprietor?:No
Enumeration Date:2011-07-20
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator