Individual
ROBERTA CHAMPOUILLON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5310 HOMESTEAD RD NE BLDG 4, ALBUQUERQUE, NM 87110-1524
(505) 256-3648
Mailing address
4101 CENTRAL AVE NE APT 3005, ALBUQUERQUE, NM 87108-1961
(423) 483-4310
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
68592
NM
Other
Enumeration date
06/23/2022
Last updated
06/23/2022
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