Individual
NANCY A BALTUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9551 PASEO DEL NORTE NE, UNIT D, ALBUQUERQUE, NM 87122-2975
(505) 800-7045
(505) 800-7051
Mailing address
9551 PASEO DEL NORTE NE, UNIT D, ALBUQUERQUE, NM 87122-2975
(505) 800-7045
(505) 800-7051
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
PA2003-0029
NM
363AM0700X
Medical Physician Assistant
Primary
PA2003-0029
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
79573827
—
NM
Enumeration date
10/03/2006
Last updated
07/21/2016
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