Individual
LAUREN MARIE MATTIACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
999 W AMADOR AVE, LAS CRUCES, NM 88005-2739
(575) 527-5482
Mailing address
2022 PINECONE WAY, LAS CRUCES, NM 88012-6006
(575) 527-5482
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
65402
NM
Other
Enumeration date
09/29/2021
Last updated
10/02/2021
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