Organization
EXTENDED HEALTHCARE, LLC
Active
Organization
EXTENDED HEALTHCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOAN PATRICIA LEWIS MD (CEO)
(505) 414-3996
Entity
Organization
Contact information
Practice address
2600 VERANDA RD NW, ALBUQUERQUE, NM 87107-2940
(505) 414-3996
Mailing address
2600 VERANDA RD NW, ALBUQUERQUE, NM 87107-2940
(505) 414-3996
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
364SA2200X
Adult Health Clinical Nurse Specialist
—
—
Other
Enumeration date
04/11/2016
Last updated
04/11/2016
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