| NPI | 1831802230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLEY AUTREY Credentialing 505-249-1369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2022-12-30 |
| Last Update Date | 2023-01-28 |