Provider Demographics
NPI:1821113945
Name:NARCISA D LIPANA MD PC
Entity Type:Organization
Organization Name:NARCISA D LIPANA MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR
Authorized Official - Prefix:MRS
Authorized Official - First Name:NARCISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:LIPANA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:505-546-1059
Mailing Address - Street 1:PO BOX 1519
Mailing Address - Street 2:
Mailing Address - City:DEMING
Mailing Address - State:NM
Mailing Address - Zip Code:88031
Mailing Address - Country:US
Mailing Address - Phone:505-546-1059
Mailing Address - Fax:505-546-8388
Practice Address - Street 1:1020 S 8TH ST
Practice Address - Street 2:
Practice Address - City:DEMING
Practice Address - State:NM
Practice Address - Zip Code:88030
Practice Address - Country:US
Practice Address - Phone:505-546-1059
Practice Address - Fax:505-546-8388
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM92282207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty