Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | MD2010-0620 | NM |
NPI | 1003116922 |
---|---|
Provider Name | Dr. Jennifer Louise Babcock Pierce |
First Address | Santa Fe, NM 87501-1673 |
Second Address | Santa Fe, NM 87501-1673 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2010 |
Last Update Date | 26/10/2010 |