Individual
KIMBERLY ARCHULETA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
PMG SAN MATEO, 401 SAN MATEO BLVD SE, ALBUQUERQUE, NM 87108
(505) 462-7333
(505) 462-7495
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5356
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
207VX0000X
Obstetrics Physician
Primary
R43799
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
37289578
—
NM
Enumeration date
08/31/2006
Last updated
08/14/2008
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