Individual
JACKLYN MARIE NEMUNAITIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
MSC 07 4025, I UNIVERSITY OF NEW MEXICO, ALBUQUERQUE, NM 87131-0001
(505) 925-0405
(505) 925-0408
Mailing address
800 BRADBURY DR SE STE 116, ALBUQUERQUE, NM 87106-4310
(505) 272-1476
(505) 925-0408
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD2015-0141
NM
207RH0003X
Hematology & Oncology Physician
Primary
MD2015-0141
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/19/2012
Last updated
09/26/2024
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