Individual
VENETA KIRILOVA IANAKIEVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
8300 CONSTITUTION AVE NE, ALBUQUERQUE, NM 87110-7613
(505) 291-2402
(505) 291-2599
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD2016-0729
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
Other
Enumeration date
04/15/2013
Last updated
10/19/2016
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