| NPI | 1598465221 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RIVERA Owner / Provider 505-463-1017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family |
| Additional Taxonomies | 163WR0006X Registered Nurse, Registered Nurse First Assistant |
| Enumeration Date | 2023-03-10 |
| Last Update Date | 2023-03-10 |