AGELESS MEDICAL SPA - CLINIC
Organization (NPI-2)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1518392380- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 3961 E LOHMAN AVE SUITE 12, LAS CRUCES, NM, 880118269
- Phone
- (575) 521-4888
- Fax
- (575) 521-4888
Specialties & Taxonomies
Nurse Practitioner, Women's Health
License: NM #CNP02155
Nurse Practitioner, Family
Primary License: NM #CNP02129