Individual
JENNIFER L TSO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
504 ELM ST NE, ALBUQUERQUE, NM 87102-2512
(505) 841-1000
Mailing address
407 S SCHWARTZ AVE, SUITE 101, FARMINGTON, NM 87401-5954
(505) 609-6770
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA20060036
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
81427212
—
NM
01
—
PA2006-0036
NM LICENSE
—
05
—
PENDING
—
AZ
05
—
PENDING
—
CO
Enumeration date
11/01/2006
Last updated
10/09/2024
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