Individual
JOANN BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
520 N MAIN ST, BELEN, NM 87002-3720
(505) 966-1000
Mailing address
601 GOEBEL AVE, BELEN, NM 87002-3619
(505) 715-9200
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R58266
NM
Other
Enumeration date
07/28/2015
Last updated
07/28/2015
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