Individual
JACQUELYN SANDOVAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5850 EUBANK BLVD NE STE B 32, ALBUQUERQUE, NM 87111
(505) 200-2860
Mailing address
14671 TELEGRAPH ROAD, REDFORD, MI 48239
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
79545
NM
363LF0000X
Family Nurse Practitioner
Primary
79545
NM
Other
Enumeration date
10/08/2024
Last updated
08/26/2025
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