Individual
SUSANNA NILA BASAPPA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
MSC09 5040 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-6607
(505) 272-8045
Mailing address
MSC09 5040 1 UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 272-6607
(505) 272-8045
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
RS2023-1193
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
03/28/2023
Last updated
11/19/2024
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