Individual
JEANNE M CORNS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
5550 WYOMING BLVD NE, PMG WYOMING, ALBUQUERQUE, NM 87109
(505) 291-5300
(505) 291-5303
Mailing address
PO BOX 26666, PHS PROVIDER ENROLLMENT, ALBUQUERQUE, NM 87125-6666
(505) 923-5355
(505) 923-5354
Taxonomy
Speciality
Code
Description
License number
State
103TP0814X
Psychoanalysis Psychologist
Primary
R45190
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
21252581
—
NM
Enumeration date
12/04/2006
Last updated
07/13/2023
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