Provider Demographics
NPI:1902221005
Name:FOLEY, ANNMARIE (FNP)
Entity Type:Individual
Prefix:
First Name:ANNMARIE
Middle Name:
Last Name:FOLEY
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:PO BOX 6310
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88006-6310
Mailing Address - Country:US
Mailing Address - Phone:575-556-1898
Mailing Address - Fax:575-556-5959
Practice Address - Street 1:4672 SONOMA RANCH BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-7167
Practice Address - Country:US
Practice Address - Phone:575-556-1879
Practice Address - Fax:575-556-1880
Is Sole Proprietor?:No
Enumeration Date:2014-02-26
Last Update Date:2016-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-02996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM62036238Medicaid
NM62036238Medicaid