Most Relevant Information
Provider Data
| NPI Number: | 1003644378 |
| Provider Name: | BIKAL WAGLE |
| Entity Type: | Individual |
| Taxonomy Code: | 363L00000X |
| Specialty: | Nurse Practitioner |
| License Number: | 80090 |
Most Important Dates
| Enumeration Date: | 07/26/2024 |
| Last Updated: | 07/26/2024 |
Provider Practice Location
5400 GIBSON BLVD SE
ALBUQUERQUE
NM
871085566
Practice Location Phone/Fax
| Phone: | 5058425550 |
| Fax: |
Provider Mailing Location
8327 GARDENBROOK PL NW
ALBUQUERQUE
NM
871205614
Provider Mailing Phone/Fax
| Phone: | 5056293758 |
| Fax: |