Individual
ILANA LUCIA BACHICHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, FNP-BC
Contact information
Practice address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(505) 425-6788
(505) 425-5408
Mailing address
PO BOX 627, RIBERA, NM 87560-0627
(505) 603-8481
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
72114
NM
Other
Enumeration date
02/20/2023
Last updated
03/15/2023
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