Individual
GINA VILLANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1501 SAN PEDRO DR SE # 119, ALBUQUERQUE, NM 87108-5153
(518) 727-4188
Mailing address
1501 SAN PEDRO DR SE # 119, ALBUQUERQUE, NM 87108-5153
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00008802
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
RP00008802
NEW MEXICO BOP
NM
Enumeration date
09/07/2017
Last updated
06/16/2018
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