Individual
NAKISHA RAE ANTONIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1815 WELLS ST, LAS CRUCES, NM 88003-1304
(575) 646-5038
Mailing address
3280 HILLRISE DR, LAS CRUCES, NM 88011-4778
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
NM
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
NM
Other
Enumeration date
09/13/2017
Last updated
09/13/2017
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