Individual
MS. KETURA PREYA WISNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
5700 HARPER DR NE STE 410, ALBUQUERQUE, NM 87109-3585
(505) 843-7813
(505) 843-6947
Mailing address
5700 HARPER DR NE STE 410, ALBUQUERQUE, NM 87109-3585
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
A-2079-17
NM
207VX0201X
Gynecologic Oncology Physician
Primary
A-2079-17
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
07/01/2010
Last updated
06/27/2023
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