Individual
AUDRA LUCIA KOCHANSKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4401 MASTHEAD ST NE, SUITE 120, ALBUQUERQUE, NM 87109-4493
(505) 243-7729
Mailing address
12231 ACADEMY RD NE, #301-229, ALBUQUERQUE, NM 87111-7236
(512) 415-9339
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
00452
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
29906512
—
NM
Enumeration date
08/09/2005
Last updated
07/02/2013
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