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Individual

MISS EMILY CATHERINE WABICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
4801 BECKNER RD LEVEL 2 POD 2 STE 2650, OBSTETRICS AND GYNECOLOGY - SANTA FE, SANTA FE, NM 87507-3641
(505) 772-2000
(505) 772-1749
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2020-0083
NM
363AM0700X
Medical Physician Assistant
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
73109045
NM
Enumeration date
10/02/2018
Last updated
11/03/2023
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