Individual
PATRICIA HERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
C.R.N.P.
Contact information
Practice address
1100 CENTRAL AVE SE, PALLIATIVE CARE, ALBUQUERQUE, NM 87106-4930
(505) 252-7393
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
R161673
MD
363LA2200X
Adult Health Nurse Practitioner
CNP01391
NM
363LG0600X
Gerontology Nurse Practitioner
Primary
CNP01391
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
407573100
—
MD
Enumeration date
05/13/2006
Last updated
08/10/2018
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