Individual
LISA SANDERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1608 ISLETA BLVD SW, ALBUQUERQUE, NM 87105-4634
(505) 907-8311
Mailing address
2303 MEADOW RD SW, ABQ, NM 87105
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
08043R
NM
Other
Enumeration date
01/08/2009
Last updated
01/08/2009
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