Healthcare Provider Details

I. General information

NPI: 1962838516
Provider Name (Legal Business Name): JANA SOLTERO PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MISS JANA GAUNTT

II. Dates (important events)

Enumeration Date: 09/15/2013
Last Update Date: 03/05/2025
Certification Date: 03/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6100 PAN AMERICAN FREEWAY NE STE 200 FAMILY MEDICINE
ALBUQUERQUE NM
87109-3401
US

IV. Provider business mailing address

PO BOX 26666
ALBUQUERQUE NM
87125-6666
US

V. Phone/Fax

Practice location:
  • Phone: 505-823-8282
  • Fax: 505-823-8275
Mailing address:
  • Phone: 505-823-8282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA-2013-0065
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA2013-0065
License Number StateNM
# 3
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA-2013-0065
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: