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PEGGY NODERAMA MACASIEB

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN-FNP

Contact information

Practice address
40 FIRST PLAZA CTR NW STE 62, ALBUQUERQUE, NM 87102-6543
(505) 242-4800
Mailing address
5981 JEFFERSON ST NE STE A, ALBUQUERQUE, NM 87109-3457
(505) 370-9600

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
F0522055
NM
363LF0000X
Family Nurse Practitioner
Primary
F0522055
NM

Other

Enumeration date
05/11/2022
Last updated
10/24/2022
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