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Individual

MS. JENNIFER LYDIA CASTRO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP-C

Contact information

Practice address
333 MONTANO RD NW STE A1, ALBUQUERQUE, NM 87107-5200
(505) 777-3003
Mailing address
PO BOX 740018, ATLANTA, GA 30374-0018
(773) 352-1517
(312) 929-0373

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F04190449
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F04190449
AANP CERTIFICATION BOARD
Enumeration date
04/27/2019
Last updated
04/30/2024
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