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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
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