Individual
BRENDA F BONGETTA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3331 DEL REY BLVD, LAS CRUCES, NM 88012-7713
(575) 373-1033
Mailing address
PO BOX 370, HATCH, NM 87937-0370
(575) 267-3270
(575) 267-1747
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2019-0064
NM
Other
Enumeration date
08/11/2019
Last updated
09/20/2022
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