Most Relevant Information
Provider Data
| NPI Number: | 1003180423 |
| Provider Name: | AUDREY ANN BAUTISTA NP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | CNP-01570 |
Most Important Dates
| Enumeration Date: | 03/02/2012 |
| Last Updated: | 03/01/2019 |
Provider Practice Location
NW METRO VA CLINIC
1760 GRANDE BLVD
RIO RANCHO
NM
87124
Practice Location Phone/Fax
| Phone: | 5058967200 |
| Fax: | 5059944285 |
Provider Mailing Location
NW METRO VA CLINIC
1760 GRANDE BLVD
RIO RANCHO
NM
87124
Provider Mailing Phone/Fax
| Phone: | 5058967200 |
| Fax: | 5059944285 |