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General NPI Number Information
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NPI Number | 1114411246
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Entity Type | Individual
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Provider Name | EMILIA ROSA VESPER M.D.
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Gender | Female
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Dates
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Enumeration Date | 06/21/2018
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Last Update Date | 03/19/2025
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Provider Practice Location Address
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Address Line | 7704 2ND ST NW STE A
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-6755
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Country | US
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Telephone | 505-873-7400
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Fax |
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Provider Business Mailing Address
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Address Line | 1231 CANDELARIA RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87107-5141
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Country | US
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Telephone | 505-345-3244
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Fax | 505-344-4056
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2020-1186
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License Number State | NM
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | RS2018-0573
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License Number State | NM
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