Provider Demographics
NPI:1861027179
Name:ARCINIEGA, REBECCA JOY (FNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:JOY
Last Name:ARCINIEGA
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3958 AGUA DE VIDA DR
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7962
Mailing Address - Country:US
Mailing Address - Phone:575-650-3324
Mailing Address - Fax:
Practice Address - Street 1:3958 AGUA DE VIDA DR
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-7962
Practice Address - Country:US
Practice Address - Phone:575-650-3324
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-06
Last Update Date:2024-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM59675363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily