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Individual

JONAH HUBBELL PANOWSKI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2111
Mailing address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2111

Taxonomy

Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
75399
NM
363LG0600X
Gerontology Nurse Practitioner
75399
NM

Other

Enumeration date
08/25/2023
Last updated
11/16/2023
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