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Individual

LINDA DOMINGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
883 LEAD AVENUE SE SUITE A, ALB, NM 87102
(505) 843-7131
(505) 246-9421
Mailing address
883 LEAD AVE SE, STE A, ALBUQUERQUE, NM 87102-3644
(505) 843-7131
(505) 246-9421

Taxonomy

Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
R20342
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
91447
NM
Enumeration date
03/21/2006
Last updated
08/13/2008
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