Individual
BONNIE M BAXTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-0600
(505) 727-9590
Mailing address
6701 JEFFERSON ST NE, ALBUQUERQUE, NM 87109-4318
(505) 727-0600
(505) 727-9590
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
CNP01179
NM
363LF0000X
Family Nurse Practitioner
Primary
CNP01179
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
80503811
—
NM
01
—
A031
TRICARE
NM
Enumeration date
06/17/2006
Last updated
09/23/2021
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