Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DR0055731 | CO |
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | DR.0055731 | CO |
NPI | 1750793238 |
---|---|
Provider Name | Stephanie Lape |
First Address | Albuquerque, NM 87131-0001 |
Second Address | Albuquerque, NM 87131 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/06/2014 |
Last Update Date | 02/07/2018 |