Individual
VONDA J BACA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
110 SHEEPSPRINGS WAY ST, JEMEZ PUEBLO, NM 87024
(505) 834-7413
Mailing address
231 CANAL ST, JEMEZ PUEBLO, NM 87024
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
R50136
NM
Other
Enumeration date
02/02/2007
Last updated
07/08/2007
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