Individual
LARISSA BALDONADO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1202 MAIN ST NE STE A, LOS LUNAS, NM 87031-7421
(505) 565-0070
Mailing address
1700 TESORO LOOP NW, LOS LUNAS, NM 87031-8963
(505) 720-5212
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
RN-82564
NM
363LF0000X
Family Nurse Practitioner
Primary
78581
NM
Other
Enumeration date
10/31/2017
Last updated
03/10/2025
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