Individual
AMANDA LACASSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
6400 UPTOWN BLVD NE SUITE 360 WEST, ALBUQUERQUE, NM 87110
(505) 296-4871
Mailing address
PO BOX 25704, ALBUQUERQUE, NM 87125-0704
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
RN-77497
NM
Other
Enumeration date
03/01/2018
Last updated
03/01/2018
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