Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Small Town Family Practice LLC

Organization Registered Nurse · NPI 1164194940

Small Town Family Practice LLC is a Registered Nurse in Albuquerque, New Mexico. Registered with an NPI since 2021.

In the registry since
2021
Specialties on file
5
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4225 Montgomery Blvd NE
Albuquerque, NM 87109-1103
Phone: (505) 366-3635
Fax: (505) 221-5429
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Primary Care Clinic/Center (primary) Taxonomy 261QP2300X
Registered Nurse Taxonomy 163W00000X
Family Medicine Physician Taxonomy 207Q00000X
Family Nurse Practitioner Taxonomy 363LF0000X
Primary Care Nurse Practitioner Taxonomy 363LP2300X

Record details

NPI number1164194940
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Deanna Clark — Co-Owner/ Co-Manager · (505) 366-3635
NPI enumeratedSeptember 30, 2021
Last updated in NPPESSeptember 30, 2021
Certification dateSeptember 30, 2021
Mailing address4225 Montgomery Blvd Ne, Albuquerque, NM 87109-1103

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