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Doctors / NM
NURSE PRACTITIONER
Graduated: 2020
NPI: 1114531100
2129 OSUNA RD NE
ALBUQUERQUE, NM 871131002
ALBUQUERQUE, NM 871137001
PO BOX, SUITE 13624
LAS CRUCES, NM 88013
Source: CMS National Downloadable File, September 2026.