Individual
MARYAM BORNAEI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7801 ACADEMY RD NE, ALBUQUERQUE, NM 87109-3379
(505) 272-2700
(505) 272-6308
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-3120
(580) 527-2806
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
CNP-01902
NM
Other
Enumeration date
12/20/2011
Last updated
05/16/2012
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