Individual
MY HA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
1100 CENTRAL AVE SE, 4TH FL SUITE B, ALBUQUERQUE, NM 87106-4930
(505) 724-6124
(505) 724-6125
Mailing address
PO BOX 26666, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-02743
NM
363LC0200X
Critical Care Medicine Nurse Practitioner
CNP-02743
NM
Other
Enumeration date
08/11/2015
Last updated
03/13/2025
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