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NPI Code Detail

MEDICARE: JESSICA R PROCHNOW RNFA

MEDICARE: JESSICA R PROCHNOW RNFA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WR0006XRegistered Nurse First Assistant71020NM

General Provider Information

NPI Number : 1144487307
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA R PROCHNOW RNFA
Provider Business Mailing Address
First Line : PO BOX 56785
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87187-6785
Country : US
Telephone Number : 214-227-2457
Fax Number : 214-764-0880
Provider Business Practice Location Address
First Line : 8300 CONSTITUTION AVE NE
Second Line :
City : ALBUQUERQUE
State : NM
Zip : 87110-7613
Country : US
Telephone Number : 214-227-2457
Fax Number : 214-764-0880
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2008
Last Update Date : 06/16/2022

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Directions to “ JESSICA R PROCHNOW RNFA” Practice Location

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