Individual
CHRISTINE ROSEANN IDEMUDIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-CNP
Contact information
Practice address
1950 S SONOMA RANCH BLVD, LAS CRUCES, NM 88011-1706
(575) 525-4811
(575) 525-4812
Mailing address
385 CALLE DE ALEGRA STE A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266
Taxonomy
Speciality
Code
Description
License number
State
171400000X
Health & Wellness Coach
—
—
363LF0000X
Family Nurse Practitioner
Primary
67455
NM
363LP2300X
Primary Care Nurse Practitioner
67455
NM
Other
Enumeration date
03/26/2022
Last updated
03/15/2025
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