Individual
JOCELYN LARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
258 EL CERRO LOOP, LOS LUNAS, NM 87031-9505
(505) 414-0635
Mailing address
15 LAS BORREGAS, BELEN, NM 87002-9599
(505) 414-0635
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
54915
NM
Other
Enumeration date
01/07/2019
Last updated
12/05/2019
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