Individual
LAURIE MENDIOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP, PMHNP-BC, FNP-B
Contact information
Practice address
3150 CARLISLE BLVD NE STE 108, ALBUQUERQUE, NM 87110-1680
(505) 830-6018
(505) 830-6025
Mailing address
7112 PORTULACA DR NW, ALBUQUERQUE, NM 87120-2763
(505) 553-2278
(505) 508-1569
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
R53580
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
R53580
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
44384777
—
NM
Enumeration date
07/19/2006
Last updated
01/07/2008
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