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Individual

REGINA PRAIRIE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1001 YALE BLVD NE, ALBUQUERQUE, NM 87106
(505) 272-0371
Mailing address
1001 YALE BLVD NE, ALBUQUERQUE, NM 87106-3825
(505) 272-0371

Taxonomy

Speciality
Code
Description
License number
State
163WP0807X
Child & Adolescent Psychiatric/Mental Health Registered Nurse
Primary
RN-84371
NM

Other

Enumeration date
08/06/2019
Last updated
08/06/2019
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