Individual
SAMANTHA MATTEUCCI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ACNPC-AG
Contact information
Practice address
504 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
Mailing address
3149 LLANO VISTA CT NE, RIO RANCHO, NM 87124-5505
(505) 401-2032
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
64551
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64551
APRN-CNP LICENSE
NM
Enumeration date
07/19/2021
Last updated
10/06/2021
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