Individual
ANDREA E MALONEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
7103 4TH ST NW STE C, LOS RANCHOS, NM 87107-6675
(505) 433-3994
(505) 433-2748
Mailing address
7103 4TH ST NW STE C, LOS RANCHOS, NM 87107-6675
(505) 433-3994
(505) 433-2748
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-03464
NM
363LF0000X
Family Nurse Practitioner
CNP03464
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68271077
—
NM
Enumeration date
12/15/2017
Last updated
06/16/2024
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