Individual
WANDA J PONCIK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
2445 S TELSHOR BLVD, LAS CRUCES, NM 88011-5049
(575) 521-1919
(575) 521-1676
Mailing address
PO BOX 2278, LAS CRUCES, NM 88004-2278
(575) 521-1919
(575) 521-1676
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
508505
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP01117
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
32085273
—
NM
Enumeration date
09/05/2006
Last updated
05/28/2026
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