Individual
LACI FACHINI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
805 BARTON RD, EDGEWOOD, NM 87015
(505) 832-5767
Mailing address
14 FISHBURN LN, EDGEWOOD, NM 87015-8255
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN-78718
NM
Other
Enumeration date
08/29/2024
Last updated
08/29/2024
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