Individual
JENNIFER Y. C. EDGOOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2400 TUCKER AVE NE, ALBUQUERQUE, NM 87131-3935
(505) 272-1734
(505) 272-1736
Mailing address
1 UNIVERSITY OF NEW MEXICO, MSC09 9040, ALBUQUERQUE, NM 87131-0001
(505) 272-4823
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
54451-020
WI
207Q00000X
Family Medicine Physician
Primary
MD2024-0740
NM
Other
Enumeration date
07/16/2006
Last updated
07/19/2024
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