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Individual

JANINE MANCUSI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
1100 LEAD AVE SE, ALBUQUERQUE, NM 87106-5215
(505) 224-7000
(941) 794-2893
Mailing address
PO BOX 26666, PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
60845
NM
363LF0000X
Family Nurse Practitioner
APRN11003693
FL

Other

Enumeration date
12/10/2019
Last updated
03/30/2023
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