Individual
ETHAN ADLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-BC
Contact information
Practice address
4121 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109
(505) 883-8099
(505) 299-2649
Mailing address
4121 MONTGOMERY BLVD NE, ALBUQUERQUE, NM 87109-1102
(505) 883-8099
(505) 299-2649
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNO02214
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
91924260
—
NM
Enumeration date
07/11/2013
Last updated
07/03/2018
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