Individual
DINA KOTOVA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4320 THE 25 WAY NE STE 400, ALBUQUERQUE, NM 87109-5881
(505) 808-3754
(505) 344-1060
Mailing address
4320 THE 25 WAY NE STE 400, ALBUQUERQUE, NM 87109-5881
(505) 808-3754
(505) 344-1060
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-02153
NM
363LF0000X
Family Nurse Practitioner
CNP-02153
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
93374534
—
NM
Enumeration date
04/08/2013
Last updated
02/26/2024
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