Individual
DANIELLE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
511 W CORDOVA RD, SANTA FE, NM 87505-1843
(505) 983-5546
Mailing address
1012 ESPANOLA ST NE, ALBUQUERQUE, NM 87110-7206
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP00009157
NM
Other
Enumeration date
08/22/2019
Last updated
08/22/2019
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