Provider Demographics
NPI:1487181434
Name:ARMSTRONG, RICKI L (FNP-C)
Entity Type:Individual
Prefix:
First Name:RICKI
Middle Name:L
Last Name:ARMSTRONG
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1454
Mailing Address - Street 2:
Mailing Address - City:PERALTA
Mailing Address - State:NM
Mailing Address - Zip Code:87042-1454
Mailing Address - Country:US
Mailing Address - Phone:505-869-3478
Mailing Address - Fax:
Practice Address - Street 1:1400 MAIN ST NW
Practice Address - Street 2:
Practice Address - City:LOS LUNAS
Practice Address - State:NM
Practice Address - Zip Code:87031-4812
Practice Address - Country:US
Practice Address - Phone:505-869-3478
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-20
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03240363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily