Individual
DEREK SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4934
(505) 724-6125
(505) 724-6125
Mailing address
1100 CENTRAL AVE SE, ALBUQUERQUE, NM 87106-4934
(505) 724-6125
(505) 724-6125
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
54702
NM
Other
Enumeration date
02/08/2019
Last updated
02/08/2019
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