Individual
PATRICIA DIANNE STUDERUS WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2231
Mailing address
2211 LOMAS BLVD NE, ALBUQUERQUE, NM 87106-2719
(505) 272-2231
Taxonomy
Speciality
Code
Description
License number
State
163WW0000X
Wound Care Registered Nurse
Primary
RN-88042
NM
363LF0000X
Family Nurse Practitioner
Primary
90595
NM
Other
Enumeration date
09/05/2024
Last updated
07/10/2026
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