Individual
ANNIE VALLEJOS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
3777 NM HIGHWAY 528 NW, RIO RANCHO, NM 87144-7650
(505) 404-2590
(505) 404-2591
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5770
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-02474
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
83237208
—
NM
Enumeration date
07/23/2014
Last updated
04/14/2022
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