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1619697570
ETHAN BLACKNEY-LOPEZ
ALBUQUERQUE, NM
NPI
1619697570
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LA2100X Nurse Practitioner, Acute Care
(Licence: NM 69604)
Enumeration Date
2022-08-31
Last Update Date
2023-05-26
Business Address
Mr. ETHAN BLACKNEY-LOPEZ AG-ACNP
2211 LOMAS BLVD NE
ALBUQUERQUE, NM 87106-2719
Phone number: 505-272-2711
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Mailing Address
Mr. ETHAN BLACKNEY-LOPEZ AG-ACNP
9 SENA DR
LOS LUNAS, NM 87031-6948
Phone number: 505-507-3987
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