IndividualActive
Dawn Back, PA
NPI 1841273554 · Physician Assistant · Santa Rosa, NM
Provider details
- NPI number
- 1841273554
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- PA2016-0044 (NM)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
117 Camino De Vida
Suite 300
Santa Rosa, NM 88435
Phone: (575) 472-4311
Fax: (575) 472-4313
Approximate (ZIP-level) locationGet directions
Mailing address
117 Camino De Vida
Santa Rosa, NM 88435
Registry dates
- Enumerated
- 2005-11-28
- Last updated
- 2017-02-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.