Individual
AMANDA L WENGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
13A SAN MARCOS LOOP, SANTA FE, NM 87508-7083
(505) 986-4000
Mailing address
1321 E POPLAR ST, DEMING, NM 88030-4807
(575) 546-5951
(575) 546-5994
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
L18298
NM
Other
Enumeration date
02/21/2023
Last updated
02/21/2023
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