Organization · NPI-2

Functional Family Medicine

Clinical Nurse Specialist, Family Health · Albuquerque, NM

NPI number1932509403
StatusActive
Last updated in NPPESSep 2, 2014

Details

NPI
1932509403
Entity type
Organization (NPI-2)
Legal business name
Functional Family Medicine
Organization subpart
No
Enumeration date
Sep 2, 2014
Last updated
Sep 2, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
364SF0001X Clinical Nurse Specialist, Family Health––Yes

Practice location

7301 Jefferson St Ne Ste G
Albuquerque, NM 87109-4363

Phone 505-225-4044 · Fax 505-508-5284

Mailing address

7301 Jefferson St Ne Ste G
Albuquerque, NM 87109-4363

Phone 505-225-4044 · Fax 505-508-5284

Authorized official

Camille Johnson
Owner
5055501183

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