Halcyon Health of the Southwest, LLC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

CNP-02392 Issued in NM

Legal business name

HALCYON HEALTH OF THE SOUTHWEST, LLC

Practice address

1355 California Ave Ste B
Las Cruces, NM 88001

Phone

(575) 523-8951

Fax

(575) 366-8011

NPI assigned

Aug 8, 2018

Organization subpart

No

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

Authorized official

Name

Misti Lynn, FNP-C

Title

Owner / Provider

Phone

(931) 636-6648

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1533686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1544054400000",
    "number": "1760961908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1355 CALIFORNIA AVE STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880014187",
            "telephone_number": "575-523-8951",
            "fax_number": "575-366-8011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1355 CALIFORNIA AVE STE B",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "88001",
            "telephone_number": "575-523-8951",
            "fax_number": "575-366-8011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HALCYON HEALTH OF THE SOUTHWEST, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-08",
        "last_updated": "2018-12-06",
        "status": "A",
        "authorized_official_last_name": "LYNN",
        "authorized_official_first_name": "MISTI",
        "authorized_official_title_or_position": "OWNER / PROVIDER",
        "authorized_official_telephone_number": "931-636-6648",
        "authorized_official_credential": "FNP-C"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Nurse Practitioner",
            "state": "NM",
            "license": "CNP-02392",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "64634876",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2018; 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.