Mardo, Laura

Mardo, Laura is an individual health care provider with primary practice located at 117 Camino De Vida Suite 300, Santa Rosa NM 88435-2267. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Mardo, Laura can be contacted via phone (575) 472-4311.

Contact Information

Primary practice address
117 Camino De Vida Suite 300 Santa Rosa NM 88435-2267
Phone: (575) 472-4311
Fax: (575) 472-4313
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X CNP-02904 New Mexico

Profile Details

NPI number 1720432271
LBN Legal business name Mardo, Laura
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 21st, 2016
Last updated Aug 31st, 2016 - about 8 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1720432271 NPPES
New Mexico MEDICAID 81833288

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