Cynthia Amaya, CPNP-PC

Individual provider Active NPI Pediatrics Physician · Roswell, NM

NPI 1104497148 · NPPES record last updated Jul 9, 2021

Key facts

NPI
1104497148
Entity type
Individual (NPI type 1)
Primary specialty
Pediatrics Physician 208000000X
License
APRN-CNP-64439 (NM)
Practice address
813 N Washington Ave
Roswell, NM 88201-3941
Phone
(575) 622-2606
NPI assigned
Jul 9, 2021
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NM
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210909002137 NM Practitioner - Pediatric Medicine 9931505377

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
APRN-CNP-64439NMMDPediatrics Physician

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X APRN-CNP-64439 NM Yes

Addresses

Primary practice location

813 N Washington Ave
Roswell, NM 88201-3941

Mailing address

813 N Washington Ave
Roswell, NM 88201-3941
Phone (575) 622-2606

Other providers in Roswell, NM

All providers in Roswell, NM · Pediatrics Physician in New Mexico

Sources for this page

Verify at the official NPI Registry.