DESIREE RENEE PROVENCIO

ALBUQUERQUE, NM
NPI1336648328
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: NM  CNP-03491)
Enumeration Date2018-02-06
Last Update Date2025-11-18
Business Address
Dr. DESIREE RENEE PROVENCIO DNP, CNP, PMHNP-BC
9384 VALLEY VIEW DR NW STE 400
ALBUQUERQUE, NM 87114-4403
Phone number: 505-225-3110
Mailing Address
Dr. DESIREE RENEE PROVENCIO DNP, CNP, PMHNP-BC
PO BOX 45450
RIO RANCHO, NM 87174-5450
Phone number: 505-225-3110