Individual
JOE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2300 YALE BLVD SE, ALBUQUERQUE, NM 87106-4273
(505) 206-5643
(505) 420-4855
Mailing address
2300 YALE BLVD SE, ALBUQUERQUE, NM 87106-4273
(505) 206-5643
(505) 420-4855
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
1433
NM
175T00000X
Peer Specialist
Primary
1433
NM
Other
Enumeration date
04/05/2024
Last updated
05/08/2026
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