Gonzales, Autumn Marie
Gonzales, Autumn Marie is an sole proprietor health care provider with primary practice located at 3917 West Rd Ste A , Los Alamos NM 87544-2292. She recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Medical is her primary health care specialty. Gonzales, Autumn Marie can be contacted via phone (505) 661-8900.Contact Information
Primary practice address
3917 West Rd Ste A
Los Alamos NM 87544-2292
Phone: (505) 661-8900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA2023-0240 | New Mexico |
Profile Details
| NPI number | 1073275756 |
|---|---|
| LBN Legal business name | Gonzales, Autumn Marie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 9th, 2021 |
| Last updated | Aug 9th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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