Organization
PELLE LASER SPA
Active
Other names
Pelle Spa
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ANNETTE LOUISE RANDLEMON CFNP (OWNER)
(505) 320-6249
Entity
Organization
Contact information
Practice address
4337 E MAIN ST STE 202, FARMINGTON, NM 87402-8634
(505) 326-1623
Mailing address
4337 E MAIN ST STE 202, FARMINGTON, NM 87402-8634
(505) 326-1623
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
07/10/2024
Last updated
07/10/2024
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