Individual
JENNIFER LYNN OTIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3741 RUTLEDGE RD NE, ALBUQUERQUE, NM 87109-5566
(505) 798-9300
(505) 798-0808
Mailing address
9200 LONA LN NE, ALBUQUERQUE, NM 87111-1619
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/29/2020
Last updated
10/29/2020
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