Individual
CAROLYN DIANE P. MOURAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1976 CORTA RUSTICA RD, LOS LUNAS, NM 87031-7507
(505) 865-9842
Mailing address
1976 CORTA RUSTICA RD, LOS LUNAS, NM 87031-7507
(505) 865-9842
Taxonomy
Speciality
Code
Description
License number
State
163WP2201X
Ambulatory Care Registered Nurse
Primary
R26250
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R26250
REGISTERED NURSE, NEW MEXICO LICENSE
NM
Enumeration date
07/17/2009
Last updated
01/05/2011
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