Individual
VERONICA FRANCES MATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1400 MAIN ST NW STE M, LOS LUNAS, NM 87031-4866
(505) 916-0533
Mailing address
1400 MAIN ST NW STE M, LOS LUNAS, NM 87031-4866
(505) 916-0533
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R65877
NM
363LF0000X
Family Nurse Practitioner
Primary
80605
NM
Other
Enumeration date
09/13/2023
Last updated
09/24/2024
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