Most Relevant Information
Provider Data
| NPI Number: | 1003415753 |
| Provider Name: | JESSICA WOOD |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP2300X |
| Specialty: | Nurse Practitioner |
| License Number: | 61867 |
Most Important Dates
| Enumeration Date: | 10/23/2020 |
| Last Updated: | 10/30/2024 |
Provider Practice Location
1400 MAIN ST NW
LOS LUNAS
NM
870314812
Practice Location Phone/Fax
| Phone: | 5059160533 |
| Fax: |
Provider Mailing Location
800 BRADBURY DR SE STE 116
ALBUQUERQUE
NM
871064310
Provider Mailing Phone/Fax
| Phone: | 5052721476 |
| Fax: |