Facts
- Status
- A
- Credential
- FNP-C
- Type
- Individual
- Enumeration date
- 2023-06-09
- Last updated
- 2026-03-11
Licenses
- License NM
- N-89561
- License NM
- 73995
Location
- Practice location
- 6501 4TH ST NW STE D
- City
- LOS RANCHOS NM
- Postal code
- 871075800
- Phone
- 505-431-0412
Medicare
- PECOS
- A PECOS enrollment row matches this NPI.
LEIE
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Nearby
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.