Individual
JESSICA AVILA - VALCARCEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4934
(505) 841-1234
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD2023-1590
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2021
Last updated
06/13/2024
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