Individual
LAURIE L VIGNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, CDE
Contact information
Practice address
1010 SPRUCE ST, ESPANOLA MULTI-SPECIALTY CLINIC, ESPANOLA, NM 87532-2724
(505) 753-8031
(505) 753-7433
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-6770
Taxonomy
Speciality
Code
Description
License number
State
132700000X
Dietary Manager
R27926
NM
163WD0400X
Diabetes Educator Registered Nurse
Primary
R27926
NM
Other
Enumeration date
08/20/2006
Last updated
01/08/2021
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