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Individual

MS. LINDA ROSS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CFNP

Contact information

Practice address
4001 RODEO RD, MEDICAL STAFF OFFICE, SANTA FE, NM 87507-4830
(505) 417-8994
Mailing address
4001 RODEO RD, MEDICAL STAFF OFFICE, SANTA FE, NM 87507-4830
(505) 417-8994

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
210P200X
NM

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
10000294
LOVELACE HEALTHCARE
01
202014953
PRESBYTERIAN HEALTH PLAN
05
K5783
NM
01
NM026408
BCBS
NM
01
QMYPRO0074146
MOLINA
NM
Enumeration date
08/31/2006
Last updated
09/27/2012
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