Individual
CONNIE MA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
11001 HANNETT AVE NE, ALBUQUERQUE, NM 87112-4329
(505) 948-1398
Mailing address
11001 HANNETT AVE NE, ALBUQUERQUE, NM 87112-4329
(505) 948-1398
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86061341
NM
Other
Enumeration date
09/29/2025
Last updated
09/29/2025
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