Individual
MATTHEW GREENWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
4901 LANG AVE NE STE 203, ALBUQUERQUE, NM 87109-4597
(505) 982-3113
(505) 982-2462
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
54474
NM
Other
Enumeration date
12/10/2018
Last updated
04/15/2019
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