Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LW0102X | Nurse Practitioner - Women's Health | APN.0990300-NP | CO |
Y | 363LW0102X | Nurse Practitioner - Women's Health | CNP-01920 | NM |
NPI | 1013273325 |
---|---|
Provider Name | Ms. Maxine Rose Horton |
First Address | Albuquerque, NM 87108-1434 |
Second Address | Albuquerque, NM 87108-1434 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/04/2012 |
Last Update Date | 02/04/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
15222098 | (05) | NM |