Individual
STEPHANIE MISCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
522 LOMAS BLVD NE, ALBUQUERQUE, NM 87102-2454
(505) 242-7512
Mailing address
522 LOMAS BLVD NE, ALBUQUERQUE, NM 87102-2454
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
25MA12290000
NJ
207Q00000X
Family Medicine Physician
Primary
MD2022-1222
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/13/2017
Last updated
01/29/2026
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