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Individual

MICHELLE CARRILLO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
123 MADEIRA DR SE, ALBUQUERQUE, NM 87108-2963
(505) 262-1538
Mailing address
123 MADEIRA DR SE, ALBUQUERQUE, NM 87108-2963

Taxonomy

Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
RN-74656
NM

Other

Enumeration date
03/14/2015
Last updated
09/03/2015
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