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Individual

MS. LUANN MARY WOSICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
06B MAIN STREET, ORTIZ MOUNTAIN HEALTH CENTER, CERRILLOS, NM 87010
(505) 471-6266
(505) 471-5861
Mailing address
PO BOX 148, ORTIZ MOUNTAIN HEALTH CENTER, CERRILLOS, NM 87010
(505) 471-6266
(505) 471-5861

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R20436
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
R20436
PROVIDER NO BD OF NURSING
NM
Enumeration date
08/17/2006
Last updated
07/08/2007
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