Individual
ANDREA CORMIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
719 SAN MATEO BLVD NE, ALBUQUERQUE, NM 87108-1434
(505) 265-5976
Mailing address
1617 STANFORD DR SE, ALBUQUERQUE, NM 87106-3308
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
97-PA24
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000S6401
—
NM
Enumeration date
03/01/2007
Last updated
07/08/2007
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