Individual
BERNADETTE PEREA-ZAMORA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 508-3458
(505) 508-3458
Mailing address
601 DR MARTIN LUTHER KING JR AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 550-7362
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
R46548
NM
363LF0000X
Family Nurse Practitioner
Primary
CNP-03412
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CNP-03412
NEW MEXICO BOARD OF NURSING
—
01
—
R46548
NEW MEXICO BOARD OF NURSING
—
Enumeration date
10/24/2017
Last updated
06/16/2018
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