Individual
MICHELLE RACICOT RACICOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
5341 WYOMING NE, SUIT A, ALBUQUERQUE, NM 87109-3164
(505) 244-0640
(505) 244-0642
Mailing address
5341 WYOMING NE, SUIT A, ALBUQUERQUE, NM 87109-3164
(505) 244-0640
(505) 244-0642
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R52835
NM
Other
Enumeration date
09/12/2012
Last updated
09/12/2012
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