Individual
MRS. SELENE MARIE LA MARCA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
3900 E LOHMAN AVE STE B, LAS CRUCES, NM 88011-8268
(575) 522-5752
(575) 522-5722
Mailing address
3821 MASTHEAD ST NE, ALBUQUERQUE, NM 87109-4679
(505) 998-7401
(505) 998-7740
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-02303
NM
363LA2100X
Acute Care Nurse Practitioner
CNP-02303
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
75685248
—
NM
Enumeration date
12/01/2013
Last updated
03/17/2023
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