Organization
CLITEPIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SOPHIA CHU RODGERS MSN, ACNP-C,FNP-C, (ACUTE CARE NURSE PRACTITIONER)
(505) 401-0810
Entity
Organization
Contact information
Practice address
700 HIGH ST NE, ALBUQUERQUE, NM 87102-2565
(505) 401-0810
(505) 858-1467
Mailing address
12231 ACADEMY RD NE, #301-223, ALBUQUERQUE, NM 87111-7236
(505) 792-6590
(505) 858-1467
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
CNP00285
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q5234
—
NM
Enumeration date
03/23/2011
Last updated
01/25/2013
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