Individual
NICOLE AVERY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 GOLD AVE SW STE 1300W, ALBUQUERQUE, NM 87102-3283
(505) 449-8729
Mailing address
PO BOX 94508, ALBUQUERQUE, NM 87199-4508
(505) 449-8729
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
NM
171M00000X
Case Manager/Care Coordinator
—
—
Other
Enumeration date
10/24/2022
Last updated
04/16/2024
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