Organization
UNM MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY LAFOND (PROVIDER ENROLLMENT COORDINATOR)
(505) 272-8950
Entity
Organization
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2745
(505) 272-2111
Mailing address
933 BRADBURY DR SE, SUITE 2222, ALBUQUERQUE, NM 87106-4374
(505) 272-8950
(505) 272-8060
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
612850
TX
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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