Organization
PETROGLYPH PRIMARY CARE AND CONSULTING LLC
Active
Organization
PETROGLYPH PRIMARY CARE AND CONSULTING LLC
Active
Other names
Petroglyph Primary Care
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL M ARCHULETA DNP, APRN, AGACNP-BC (NURSE PRACTITIONER)
(505) 502-4401
Entity
Organization
Contact information
Practice address
525 CHAVEZ ST, LAS VEGAS, NM 87701-3221
(505) 819-8434
Mailing address
6512 PATO RD NW, ALBUQUERQUE, NM 87120-7007
(505) 502-4401
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
70802777
—
NM
Enumeration date
08/17/2023
Last updated
01/13/2024
Update your record
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