Individual
PATRICIA BACA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
85 W HIGHWAY 22, SANTO DOMINGO PUEBLO, NM 87052-1283
(505) 465-3060
(505) 318-1079
Mailing address
PO BOX 340, ST DMNG PBLO, NM 87052-0340
(505) 465-3060
(505) 318-1079
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN-72420
NM
163WW0000X
Wound Care Registered Nurse
RN-72420
NM
Other
Enumeration date
10/25/2024
Last updated
10/25/2024
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