Individual
JESSICA BARTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
2400 UNSER BLVD SE, RIO RANCHO, NM 87124-4740
(505) 253-7878
Mailing address
35 VISTA LARGA PL NE, RIO RANCHO, NM 87124-4371
(505) 702-2273
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
57450
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
57450
BOARD OF NURSING
NM
Enumeration date
08/28/2019
Last updated
08/28/2019
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