Individual
LISA SPERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
201 PUEBLO VIEW, PENASCO, NM 87553
(575) 251-8010
(833) 438-5215
Mailing address
PO BOX 755, ARROYO SECO, NM 87514-0755
(816) 896-5472
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
59011
NM
363LF0000X
Family Nurse Practitioner
Primary
59011
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H3451
—
NM
Enumeration date
11/27/2019
Last updated
04/22/2025
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