Individual
AMY PENDERGRAFT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1691 GALISTEO ST STE C, SANTA FE, NM 87505-4781
(505) 983-5631
Mailing address
1691 GALISTEO ST STE C, SANTA FE, NM 87505-4781
(505) 983-5631
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
879769
NM
363LF0000X
Family Nurse Practitioner
Primary
81358
NM
Other
Enumeration date
06/01/2016
Last updated
04/03/2025
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