Individual
MAYEDEL SAN JOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
1245 COUNTRY CLUB RD STE 200, SANTA TERESA, NM 88008-9743
(575) 332-4633
Mailing address
1245 COUNTRY CLUB RD STE 200, SANTA TERESA, NM 88008-9743
(575) 332-4633
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
AP130851
TX
363LF0000X
Family Nurse Practitioner
Primary
CNP-03155
NM
Other
Enumeration date
04/22/2016
Last updated
12/11/2024
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