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General NPI Number Information
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NPI Number | 1376259747
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Entity Type | Individual
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Provider Name | PATRICIA DIANE OLGUIN FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 01/27/2023
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Last Update Date | 01/27/2023
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Provider Practice Location Address
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Address Line | 10501 LAGRIMA DE ORO RD NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87111-3737
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Country | US
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Telephone | 505-293-4001
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Fax |
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Provider Business Mailing Address
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Address Line | 8604 BOUVARDIA AVE NW
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City | ALBUQUERQUE
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State | NM
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Zip | 87120-4270
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Country | US
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Telephone | 505-307-4506
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 71703
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License Number State | NM
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