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Individual

AUDRIANA APODACA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPNP

Contact information

Practice address
100 AIRPORT RD, SANTA TERESA, NM 88008
(575) 874-9338
(575) 874-9359
Mailing address
385 CALLE DE ALEGRA, BLDG. A, LAS CRUCES, NM 88005-3423
(575) 526-1105
(575) 524-4266

Taxonomy

Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
AP126833
TX
363LP0200X
Pediatric Nurse Practitioner
Primary
CNP-02940
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
252452YRND
MEDICARE
NM
05
96479779
NM
Enumeration date
11/10/2014
Last updated
08/28/2018
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