Individual
JAMIE LYNN HEREDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
501 S ABILENE AVE, PORTALES, NM 88130-6380
(575) 356-7090
(575) 356-2846
Mailing address
PO BOX 847, PORTALES, NM 88130-0847
(575) 562-4458
(575) 562-4460
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
834335
TX
Other
Enumeration date
08/16/2024
Last updated
08/16/2024
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