Individual
NICHOLAS F. ROCKEFELLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
6100 PAN AMERICAN FREEWAY NE, STE 450, ALBUQUERQUE, NM 87109-3460
(505) 823-8787
Mailing address
6420 CLAYTON RD, SAINT LOUIS, MO 63117-1811
(314) 768-8000
(314) 645-8771
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
2014020090
MO
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
Primary
MD2021-0817
NM
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
RS2018-0404
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
04/30/2014
Last updated
09/01/2021
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