Organization
NORTHERN NEW MEXICO HEALTH CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JONATHAN KARL FREDERIKSEN (PRESIDENT-OWNER)
(505) 757-6666
Entity
Organization
Contact information
Practice address
18648 HWY 84-285, #C, ESPANOLA, NM 87532
(505) 753-7576
(505) 753-7676
Mailing address
1421 LUISA ST STE R, SANTA FE, NM 87505-4073
(505) 753-7576
(505) 753-7676
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
02/15/2007
Last updated
06/22/2026
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