Individual
LETICIA A LUKETICH MARTINEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2010 INDUSTRIAL PARK RD, ESPANOLA, NM 87532-3600
(505) 753-7218
(505) 747-7396
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
(505) 747-7396
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-03536
NM
Other
Enumeration date
05/21/2018
Last updated
05/21/2018
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