Individual
LIANA MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
715 E IDAHO AVE, LAS CRUCES, NM 88001-4703
(505) 584-0134
Mailing address
4320 BOGART LN, LAS CRUCES, NM 88007-5507
(505) 584-0134
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
2061
NM
Other
Enumeration date
05/12/2026
Last updated
05/12/2026
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