Individual
ROSE MARIE MCDONALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
901 BACA STREET, LAS VEGAS, NM 87701
(505) 454-3218
(877) 553-1272
Mailing address
PO BOX 158, ESPANOLA, NM 87532-0158
(505) 753-7218
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F05200430
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
85974366
—
NM
Enumeration date
09/01/2020
Last updated
10/03/2024
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