Individual
THAO NELSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
6125 4TH ST NW, ALBUQUERQUE, NM 87107-5755
(505) 344-2363
Mailing address
2501 WISCONSIN ST NE, ALBUQUERQUE, NM 87110-3753
(505) 238-5015
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00008982
NM
Other
Enumeration date
11/19/2018
Last updated
11/19/2018
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