Individual
MISS PRISCILA MELLO CORREA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.PH.
Contact information
Practice address
2210 MIGUEL CHAVEZ RD, # 1515, SANTA FE, NM 87505-6923
(505) 577-6391
Mailing address
2210 MIGUEL CHAVEZ RD, # 1515, SANTA FE, NM 87505-6923
(505) 577-6391
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00006769
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP00006769
PHARMACIST
NM
Enumeration date
10/22/2007
Last updated
10/22/2007
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