Individual
SOPHIA THIYAGARAJAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2901 TRANSPORT ST SE, ALBUQUERQUE, NM 87106-4382
(505) 262-7451
(505) 262-7870
Mailing address
PO BOX 26028, ALBUQUERQUE, NM 87125-6028
(505) 232-1617
(505) 262-7729
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
54671
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
96487810
—
NM
Enumeration date
01/11/2019
Last updated
09/28/2023
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