Individual
MARIANA BOITANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L.P.N
Contact information
Practice address
5400 GIBSON BLVD., ALBUQUERQUE, NM 87111
(505) 345-9512
Mailing address
3615 HORACIO CT., ALBUQUERQUE, NM 87111
(505) 850-6288
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN- 22377
NM
Other
Enumeration date
07/28/2016
Last updated
07/28/2016
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