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120 Aliso Dr Se Albuquerque NM 87108-2693 | |
| (505) 331-4909 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 120 Aliso Dr Se, Albuquerque, New Mexico |
| Authorized Official Name and Position | Laurel Wolcott (CERTIFIED NURSE PRACTITIONER) |
| Authorized Official Contact | 5053314909 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
120 Aliso Dr Se Albuquerque NM 87108-2693 Ph: () - | 120 Aliso Dr Se Albuquerque NM 87108-2693 Ph: (505) 331-4909 |
| NPI Number | 1770332066 |
|---|---|
| Provider Enumeration Date | 05/17/2024 |
| Last Update Date | 01/06/2025 |
| Medicare PECOS PAC ID | 0345786406 |
|---|---|
| Medicare Enrollment ID | O20240724004459 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770332066 | NPI | - | NPPES |
| Provider Name | Laurel Wolcott |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1316522030 PECOS PAC ID: 2860809787 Enrollment ID: I20210322000269 |
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