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Organization
INTEGRATED HEALTHCARE
Active
Organization
INTEGRATED HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACQUELINE EVA WILLIS NP (OWNER)
(505) 994-4503
Entity
Organization
Contact information
Practice address
4101 BARBARA LOOP SE STE C, RIO RANCHO, NM 87124-1011
(505) 994-4503
(505) 891-1495
Mailing address
4101 BARBARA LOOP SE STE C, RIO RANCHO, NM 87124-1011
(505) 994-4503
(505) 891-1495
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP-0216
NM
Other
Enumeration date
06/10/2017
Last updated
06/10/2017
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