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Individual

MS. HEATHER MARIE PINK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
4401 MASTHEAD ST NE STE 120, ALBUQUERQUE, NM 87109-4497
(505) 407-2074
Mailing address
4401 MASTHEAD ST NE STE 120, ALBUQUERQUE, NM 87109-4497
(505) 407-2074

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
55619
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
55619
BOARD OF NURSING
NM
01
CS00227074
PHARMACY BOARD
NM
01
F03190109
AMERICAN ACADEMY OF NURSE PRACTITIONERS
01
RN-76561
BOARD OF NURSING
NM
Enumeration date
04/06/2019
Last updated
07/25/2023
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