Organization
FUNCTIONAL FAMILY MEDICINE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE JOHNSON (OWNER)
(505) 550-1183
Entity
Organization
Contact information
Practice address
7301 JEFFERSON ST NE STE G, ALBUQUERQUE, NM 87109-4363
(505) 225-4044
(505) 508-5284
Mailing address
7301 JEFFERSON ST NE STE G, ALBUQUERQUE, NM 87109-4363
(505) 225-4044
(505) 508-5284
Taxonomy
Speciality
Code
Description
License number
State
364SF0001X
Family Health Clinical Nurse Specialist
Primary
—
—
Other
Enumeration date
09/02/2014
Last updated
09/02/2014
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