Individual
MARY TERESA OMEDDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
85 WEST HWY 22, SANTO DOMINGO, NM 87052
(505) 465-3060
Mailing address
PO BOX 340, SANTO DOMINGO PUEBLO, NM 87052-0340
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
65654
NM
163WC1500X
Community Health Registered Nurse
889413
TX
Other
Enumeration date
12/21/2021
Last updated
03/22/2023
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