Healthcare Provider Details

I. General information

NPI: 1336012202
Provider Name (Legal Business Name): DR. JOVENA MARIAH CLEARY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2025
Last Update Date: 09/26/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 NEW MEXICO HWY 528
RIO RANCHO NM
87124
US

IV. Provider business mailing address

7500 PIONEER TRL NE
ALBUQUERQUE NM
87109-5120
US

V. Phone/Fax

Practice location:
  • Phone: 505-896-2078
  • Fax:
Mailing address:
  • Phone: 505-620-5755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRP00010375
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: