Individual
JENNIFER L LORGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4410 IRVING BLVD NW, ALBUQUERQUE, NM 87114-5951
(505) 281-5180
(505) 702-8171
Mailing address
3917 WEST RD STE 150, LOS ALAMOS, NM 87544-5303
(505) 662-4351
(505) 662-2932
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA2020-0057
NM
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/15/2020
Last updated
02/20/2025
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