Individual
OLIVIA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
111 MONICA RD, LOS LUNAS, NM 87031-9567
(505) 865-3017
Mailing address
111 MONICA RD, LOS LUNAS, NM 87031-9567
(505) 865-3017
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
66057
NM
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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