Portillo, Diana

Portillo, Diana is an individual health care provider with primary practice located at 330 N Campo St , Las Cruces NM 88001-3433. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Primary Care, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Portillo, Diana can be contacted via phone (575) 288-1336.

Contact Information

Primary practice address
330 N Campo St Las Cruces NM 88001-3433
Phone: (575) 288-1336
Fax: (575) 222-4453
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X CNP-01613 New Mexico
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X CNP-01613 New Mexico

Profile Details

NPI number 1194049841
LBN Legal business name Portillo, Diana
Credentials DNP, FNP-C, PMHNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2010
Last updated Oct 2nd, 2020 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1194049841 NPPES
New Mexico MEDICAID 20636865
New Mexico Other NMA100470

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