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Organization
DIVINE WELLNESS AND PRIMARY CARE LLC
Active
Organization
DIVINE WELLNESS AND PRIMARY CARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARISSA BALDONADO NP (OWNER/NP)
(505) 631-0019
Entity
Organization
Contact information
Practice address
111 SANDOVAL RD SW, LOS LUNAS, NM 87031-7320
(505) 631-0019
(505) 631-0020
Mailing address
111 SANDOVAL RD SW, LOS LUNAS, NM 87031-7320
(505) 631-0019
(505) 631-0020
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
06/18/2026
Last updated
09/16/2026
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