Individual
WILLIAM B. STANFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP-BC
Contact information
Practice address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(303) 668-2258
Mailing address
1235 8TH ST, LAS VEGAS, NM 87701-4219
(303) 668-2258
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
CNP-02430
NM
363L00000X
Nurse Practitioner
NP-10153
CO
Other
Enumeration date
11/17/2009
Last updated
03/01/2024
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