Active Medical Group LLC
Nurse Practitioner, Family in Farmington, NM. Organization (NPI-2).
NPI number1992408520
StatusActive
Last updated in NPPESOct 22, 2026
Details
- NPI
- 1992408520
- Entity type
- Organization (NPI-2)
- Legal business name
- Active Medical Group LLC
- Organization subpart
- No
- Enumeration date
- Mar 23, 2023
- Certification date
- Oct 22, 2026
- Last updated
- Oct 22, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | – | – | Yes |
Practice location
4801 N Butler Ave Ste 8102Farmington, NM 87401-0818
Phone 505-370-1201 · Fax 505-461-1779
Mailing address
4801 N Butler Ave Ste 8102Farmington, NM 87401-0818
Phone 505-370-1201 · Fax 949-695-2379
Authorized official
Ashley J Smith
Fnp
5053701201
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