Individual
TAMARA WOSTAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4801 BECKNER RD, SANTA FE, NM 87507-3641
(505) 772-1007
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
60606
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
201802158RN
RN
OR
01
—
201803251NP-PP
NP-PP FAMILY
OR
01
—
840453
RN
TX
Enumeration date
05/02/2018
Last updated
08/13/2020
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