| Fenton Family Medical Llc | |
|
765 E Roosevelt Ave Grants NM 87020-2113 | |
| (505) 685-1347 | |
| Not Available |
| Full Name | Fenton Family Medical Llc |
|---|---|
| Speciality | Nurse Practitioner - Family |
| Location | 765 E Roosevelt Ave, Grants, New Mexico |
| Authorized Official Name and Position | Daniel Fenton (OWNER) |
| Authorized Official Contact | 5053151162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fenton Family Medical Llc 824 Houston Ave Grants NM 87020-3017 Ph: (505) 315-1162 | Fenton Family Medical Llc 765 E Roosevelt Ave Grants NM 87020-2113 Ph: (505) 685-1347 |
| NPI Number | 1235026261 |
|---|---|
| Provider Enumeration Date | 06/23/2025 |
| Last Update Date | 06/23/2025 |
| Certification Date | 06/22/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235026261 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Primary |
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