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DOMINIQUE PUMMILL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
601 MARTIN LUTHER KING AVE NE, ALBUQUERQUE, NM 87102-3619
(505) 288-3173
Mailing address
PO BOX 966, FAIRACRES, NM 88033-0966
(575) 805-0695

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
CNP03564
NM

Other

Enumeration date
04/30/2018
Last updated
04/30/2018
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