Provider Demographics
NPI:1356392989
Name:GORBITZ, KRISTEN (CNP)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:
Last Name:GORBITZ
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 E LOHMAN AVE STE 408
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8263
Mailing Address - Country:US
Mailing Address - Phone:575-532-7161
Mailing Address - Fax:
Practice Address - Street 1:2550 SAMARITAN DRIVE SUITE 241
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88001
Practice Address - Country:US
Practice Address - Phone:575-386-5778
Practice Address - Fax:575-680-2812
Is Sole Proprietor?:No
Enumeration Date:2006-05-16
Last Update Date:2022-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR34862363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM000Q2506Medicaid
NM000Q2506Medicaid
NM341413303Medicare PIN