Tracie Evans, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

R49161 Issued in NM

Practice address

105 W Griggs Ave
Las Cruces, NM 88001-1235

Phone

(575) 647-2879

Fax

(575) 647-2898

NPI assigned

Oct 16, 2019

Last updated

Oct 16, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• La Clinica de Familia, Incorporated

  dba Mayfield High School Base

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1134917040
  NPD (past)
• La Clinica de Familia, Incorporated

  dba LCDF Community Mental Health Clinic

  • Federally Qualified Health Center (FQHC)
  • Las Cruces, NM
  • NPI 1164802310
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1571184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571184000000",
    "number": "1144862608",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "385 CALLE DE ALEGRA STE A",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880053423",
            "telephone_number": "575-526-1105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 W GRIGGS AVE",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880011235",
            "telephone_number": "575-647-2879",
            "fax_number": "575-647-2898"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EVANS",
        "first_name": "TRACIE",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-16",
        "last_updated": "2019-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NM",
            "license": "R49161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Velia Estrada, MA
• Wesley Eric Etheridge Sr.
• Evangel Homecare Services, Inc.
• Anthony L. Evans, B.A. PSYCHOLOGY
• Carolyn Patricia Evans, P.A.
• Christina M Evaro, M.A.
• Jerry Romero Evaro, LMFT
• Everlasting Assisted Living LLC
• Evershine Care Assisted Living
• Evershine Care LLC

• Registered Nurse in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Registered Nurse in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.