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NPI Code Detail

MEDICARE: CLORINDA LEANN CORDOVA

MEDICARE:   CLORINDA LEANN CORDOVA
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
1163WS0200XSchool Registered NurseRN-71945NM

General Provider Information

NPI Number : 1053002618
Entity Type Code : Individual
Provider Name (Legal Business Name) : CLORINDA LEANN CORDOVA
Provider Business Mailing Address
First Line : 1300 CAMINO SIERRA VIS
Second Line :
City : SANTA FE
State : NM
Zip : 87505-1007
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1829 MOUNTAIN VIEW PL
Second Line :
City : LOS ALAMOS
State : NM
Zip : 87544-2882
Country : US
Telephone Number : 505-901-7818
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/16/2023
Last Update Date : 05/16/2023

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Directions to “ CLORINDA LEANN CORDOVA ” Practice Location

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