Individual
LAURA IBOA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2504 CAMINO ENTRADA, SANTA FE, NM 87507-4851
(505) 501-8974
Mailing address
PO BOX 28164, SANTA FE, NM 87592-8164
(505) 501-8974
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
64144
NM
Other
Enumeration date
07/06/2022
Last updated
07/06/2022
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