Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | R35250 | NM |
NPI | 1013104504 |
---|---|
Provider Name | Dr. Marjorie Cypress |
First Address | Albuquerque, NM 87108-4729 |
Second Address | Albuquerque, NM 87108-4729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 27/09/2007 |
Last Update Date | 10/08/2011 |