Individual
ANNETTE J LICHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2600 MARBLE NE, ALBUQUERQUE, NM 87131-0001
(505) 272-3602
Mailing address
3410 22ND AVE SE, RIO RANCHO, NM 87124-1685
(505) 891-4056
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
Primary
R44145
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
R44145
REGISTERED NURSE
NM
Enumeration date
11/18/2005
Last updated
09/14/2009
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