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Individual

ANGERENE MITCHELL-MATTHEWS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4901 LANG AVE NE, ALBUQUERQUE, NM 87109-4495
(505) 842-8171
Mailing address
626 AUTUMN OAKS LOOP, WINTER GARDEN, FL 34787-2011
(126) 720-6064

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
58573
NM
363LF0000X
Family Nurse Practitioner
11000742
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
46102329
NM
Enumeration date
12/28/2018
Last updated
06/25/2020
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