Individual
HEIDI MODESTE BARNES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHYSICIAN ASSISTANT
Contact information
Practice address
1001 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87106-4713
(505) 925-6000
Mailing address
1001 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87106-4713
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110-004701
VA
363A00000X
Physician Assistant
Primary
PA2020-0070
NM
Other
Enumeration date
11/10/2014
Last updated
11/17/2021
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