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 Date2023-11-09
Business Address
Dr. DESIREE RENEE PROVENCIO DNP, CNP, PMHNP-BC
6300 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE, NM 87120-1908
Phone number: 505-225-3110
Mailing Address
Dr. DESIREE RENEE PROVENCIO DNP, CNP, PMHNP-BC
6300 RIVERSIDE PLAZA LN NW STE 100
ALBUQUERQUE, NM 87120-1908
Phone number: 505-225-3110
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